Provider Demographics
NPI:1790152817
Name:MCCLELLAND, ABBY LEIGH (AUD)
Entity Type:Individual
Prefix:DR
First Name:ABBY
Middle Name:LEIGH
Last Name:MCCLELLAND
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6001 STONEWOOD DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7380
Mailing Address - Country:US
Mailing Address - Phone:724-940-5755
Mailing Address - Fax:724-934-2850
Practice Address - Street 1:6001 STONEWOOD DR
Practice Address - Street 2:SUITE 301
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7380
Practice Address - Country:US
Practice Address - Phone:724-940-5755
Practice Address - Fax:724-934-2850
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006452237600000X
AZDA9585237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDA9585OtherSTATE LICENSE
PAAT006452OtherSTATE LICENSE