Provider Demographics
NPI:1710746664
Name:SMITH, ABIGAIL REEVES (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:REEVES
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 N NC 241 HWY
Mailing Address - Street 2:
Mailing Address - City:BEULAVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28518-8636
Mailing Address - Country:US
Mailing Address - Phone:910-298-2331
Mailing Address - Fax:910-375-3031
Practice Address - Street 1:160 N NC 241 HWY
Practice Address - Street 2:
Practice Address - City:BEULAVILLE
Practice Address - State:NC
Practice Address - Zip Code:28518-8636
Practice Address - Country:US
Practice Address - Phone:910-298-2331
Practice Address - Fax:910-375-3031
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30001914235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist