Provider Demographics
NPI:1760683916
Name:ASHBY, ABIGAIL JEAN (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:JEAN
Last Name:ASHBY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16826 BROWNE CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-3211
Mailing Address - Country:US
Mailing Address - Phone:319-504-9185
Mailing Address - Fax:
Practice Address - Street 1:5505 GROVER ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3718
Practice Address - Country:US
Practice Address - Phone:402-558-0225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1217235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist