Provider Demographics
NPI:1508500745
Name:LOVELESS, ABIGAIL CHRISTINE
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:CHRISTINE
Last Name:LOVELESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2458 DRIFTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:MO
Mailing Address - Zip Code:63052-4301
Mailing Address - Country:US
Mailing Address - Phone:314-324-3590
Mailing Address - Fax:
Practice Address - Street 1:12563 VILLAGE CIRCLE DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1758
Practice Address - Country:US
Practice Address - Phone:314-270-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist