Provider Demographics
NPI:1427607282
Name:DORN, ABIGAIL M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:M
Last Name:DORN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 WARD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1309
Mailing Address - Country:US
Mailing Address - Phone:720-602-0384
Mailing Address - Fax:
Practice Address - Street 1:5610 WARD RD STE 300
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1309
Practice Address - Country:US
Practice Address - Phone:720-602-0384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist