Provider Demographics
NPI:1104186022
Name:FOLTZ HOTTLE, ABIGAIL JANEEN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:JANEEN
Last Name:FOLTZ HOTTLE
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 1:1337 W BARRY AVE APT 1F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4244
Mailing Address - Country:US
Mailing Address - Phone:937-417-5790
Mailing Address - Fax:
Practice Address - Street 1:1337 W BARRY AVE APT 1F
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4244
Practice Address - Country:US
Practice Address - Phone:937-417-5790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010988235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist