Provider Demographics
NPI:1144561465
Name:HABICHT, ABBY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:HABICHT
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 1:705 MAPLE ST
Mailing Address - Street 2:H 102
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-1752
Mailing Address - Country:US
Mailing Address - Phone:419-308-6438
Mailing Address - Fax:
Practice Address - Street 1:705 MAPLE ST.
Practice Address - Street 2:H 102
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205
Practice Address - Country:US
Practice Address - Phone:419-308-6438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist