Provider Demographics
NPI:1821218371
Name:DITTMAN, ABBIE J (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ABBIE
Middle Name:J
Last Name:DITTMAN
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:THE PARENTING PLACE
Mailing Address - Street 2:1500 GREEN BAY STREET
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-6455
Mailing Address - Country:US
Mailing Address - Phone:608-784-8125
Mailing Address - Fax:608-796-0098
Practice Address - Street 1:THE PARENTING PLACE
Practice Address - Street 2:1500 GREEN BAY STREET
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-6455
Practice Address - Country:US
Practice Address - Phone:608-784-8125
Practice Address - Fax:608-796-0098
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2402-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42797300Medicaid