Provider Demographics
NPI:1376166207
Name:WINGARD, ABBY J (SLP)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:J
Last Name:WINGARD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 3RD AVE S APT B
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29575-8300
Mailing Address - Country:US
Mailing Address - Phone:843-373-8102
Mailing Address - Fax:
Practice Address - Street 1:120 LAKES AT LITCHFIELD DR
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-9001
Practice Address - Country:US
Practice Address - Phone:843-237-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist