Provider Demographics
NPI:1518576388
Name:DAVIDSON, ABBIGAIL MARIE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:ABBIGAIL
Middle Name:MARIE
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:ABBIGAIL
Other - Middle Name:MARIE
Other - Last Name:MICHELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:208 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680-9648
Mailing Address - Country:US
Mailing Address - Phone:681-205-1700
Mailing Address - Fax:
Practice Address - Street 1:101 13TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-1653
Practice Address - Country:US
Practice Address - Phone:304-525-7622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVC2284224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty