Provider Demographics
NPI:1093931305
Name:JAMES, ABBY MARIE (SLP)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:MARIE
Last Name:JAMES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12741 HOBART ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-7120
Mailing Address - Country:US
Mailing Address - Phone:708-220-5104
Mailing Address - Fax:
Practice Address - Street 1:12741 HOBART ST
Practice Address - Street 2:
Practice Address - City:CEDAR LAKE
Practice Address - State:IN
Practice Address - Zip Code:46303-7120
Practice Address - Country:US
Practice Address - Phone:708-220-5104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008288235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist