Provider Demographics
NPI:1346267952
Name:JAFFE, ABIGAIL B (MA CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:B
Last Name:JAFFE
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:MS
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:BRESLOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15 BREWSTER CT
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3801
Mailing Address - Country:US
Mailing Address - Phone:413-586-1945
Mailing Address - Fax:413-586-1946
Practice Address - Street 1:15 BREWSTER CT
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3801
Practice Address - Country:US
Practice Address - Phone:413-586-1945
Practice Address - Fax:413-586-1946
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASP0098OtherBLUE CROSS BLUE SHIELD