Provider Demographics
NPI:1780841072
Name:PLUMMER, ABBI (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABBI
Middle Name:
Last Name:PLUMMER
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 1:20079 HIGHWAY P
Mailing Address - Street 2:
Mailing Address - City:VICHY
Mailing Address - State:MO
Mailing Address - Zip Code:65580-8289
Mailing Address - Country:US
Mailing Address - Phone:580-977-4880
Mailing Address - Fax:
Practice Address - Street 1:174 BALLPARK RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:MO
Practice Address - Zip Code:65582-8043
Practice Address - Country:US
Practice Address - Phone:573-422-3177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008011486235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist