Provider Demographics
NPI:1093968711
Name:ABRAHAM, JUDY MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:MARIE
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4960 S ALMA SCHOOL RD STE 21
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-5573
Mailing Address - Country:US
Mailing Address - Phone:480-883-8160
Mailing Address - Fax:480-883-8306
Practice Address - Street 1:4960 S ALMA SCHOOL RD STE 21
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-5573
Practice Address - Country:US
Practice Address - Phone:480-883-8160
Practice Address - Fax:480-883-8306
Is Sole Proprietor?:No
Enumeration Date:2008-10-25
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1008235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist