Provider Demographics
NPI:1689954042
Name:MARX, ABYGAIL E
Entity Type:Individual
Prefix:
First Name:ABYGAIL
Middle Name:E
Last Name:MARX
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 1:1500 HIGHLAND AVE
Mailing Address - Street 2:OFFICE # 327
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2274
Mailing Address - Country:US
Mailing Address - Phone:608-263-0528
Mailing Address - Fax:
Practice Address - Street 1:1500 HIGHLAND AVE
Practice Address - Street 2:OFFICE # 327
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2274
Practice Address - Country:US
Practice Address - Phone:608-263-0528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3570-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist