Provider Demographics
NPI:1134742455
Name:CORMIER, ABIGAIL ELIZABETH (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:ELIZABETH
Last Name:CORMIER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:ELIZABETH
Other - Last Name:ASSELIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SP
Mailing Address - Street 1:33 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-6313
Mailing Address - Country:US
Mailing Address - Phone:413-231-2261
Mailing Address - Fax:
Practice Address - Street 1:34 WILDWOOD AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2102
Practice Address - Country:US
Practice Address - Phone:413-231-2261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6181235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist