Provider Demographics
NPI:1871242503
Name:TAYLOR, ABIGAIL V (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:V
Last Name:TAYLOR
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 1:616 DR CALVIN JONES HWY STE 212
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-3106
Mailing Address - Country:US
Mailing Address - Phone:919-219-5277
Mailing Address - Fax:
Practice Address - Street 1:616 DR CALVIN JONES HWY STE 212
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-3106
Practice Address - Country:US
Practice Address - Phone:919-219-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15311235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist