Provider Demographics
NPI:1376011783
Name:DUEPPEN, ABIGAIL (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:DUEPPEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:CHARLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5940 PINKSTAFF LN
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-2511
Mailing Address - Country:US
Mailing Address - Phone:412-760-5423
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST STE 1723
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2747
Practice Address - Country:US
Practice Address - Phone:713-796-2181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113449235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist