Provider Demographics
NPI:1396231858
Name:RAINES, ABIGAIL P (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:P
Last Name:RAINES
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9487 DOWDEN RD APT 6104
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5680
Mailing Address - Country:US
Mailing Address - Phone:727-637-7294
Mailing Address - Fax:
Practice Address - Street 1:9487 DOWDEN RD APT 6104
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-5680
Practice Address - Country:US
Practice Address - Phone:727-637-7294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17258235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist