Provider Demographics
NPI:1093127649
Name:SCOTT, ABIGAIL (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4594 OLD SCIOTO TRL
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-6459
Mailing Address - Country:US
Mailing Address - Phone:740-464-7911
Mailing Address - Fax:
Practice Address - Street 1:7959 STATE ROUTE 124
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:OH
Practice Address - Zip Code:45646-9701
Practice Address - Country:US
Practice Address - Phone:740-493-2881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP. 10489235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist