Provider Demographics
NPI:1336564079
Name:LOVE, ABBIE LYN (OT)
Entity Type:Individual
Prefix:
First Name:ABBIE
Middle Name:LYN
Last Name:LOVE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:LYN
Other - Last Name:STAGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 450
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-0450
Mailing Address - Country:US
Mailing Address - Phone:931-722-2778
Mailing Address - Fax:
Practice Address - Street 1:514 S HIGH ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-2615
Practice Address - Country:US
Practice Address - Phone:931-722-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4606225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist