Provider Demographics
NPI:1477862373
Name:LYNCH, ABIGAIL (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:POLGLASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:868 HIGHLAND AVE # 202
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-1314
Mailing Address - Country:US
Mailing Address - Phone:203-518-1424
Mailing Address - Fax:
Practice Address - Street 1:163 LIBBEY INDUSTRIAL PKWY
Practice Address - Street 2:SUITE 302
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3137
Practice Address - Country:US
Practice Address - Phone:781-335-6663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.001588235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist