Provider Demographics
NPI:1235898495
Name:SILVA, ABIGALE MARIE
Entity Type:Individual
Prefix:
First Name:ABIGALE
Middle Name:MARIE
Last Name:SILVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LIBERTY LN UNIT 21
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-1972
Mailing Address - Country:US
Mailing Address - Phone:812-215-6994
Mailing Address - Fax:
Practice Address - Street 1:67 PINE POINT RD
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-8813
Practice Address - Country:US
Practice Address - Phone:207-883-2468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist