Provider Demographics
NPI:1154096477
Name:MISPAGEL, ABIGAIL (AUD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MISPAGEL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S NEW BALLAS RD STE 482A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8259
Mailing Address - Country:US
Mailing Address - Phone:314-251-5850
Mailing Address - Fax:
Practice Address - Street 1:621 S NEW BALLAS RD STE 482A
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8259
Practice Address - Country:US
Practice Address - Phone:314-251-5850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021029253237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter