Provider Demographics
NPI:1750051611
Name:WORTMAN, ABIGAIL (MSED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:WORTMAN
Suffix:
Gender:F
Credentials:MSED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 RACE ST UNIT 304
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-1853
Mailing Address - Country:US
Mailing Address - Phone:908-565-1922
Mailing Address - Fax:
Practice Address - Street 1:301 CHARLES ST
Practice Address - Street 2:
Practice Address - City:HURLOCK
Practice Address - State:MD
Practice Address - Zip Code:21643-3432
Practice Address - Country:US
Practice Address - Phone:908-565-1922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09817235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist