Provider Demographics
NPI:1396917878
Name:ACKERMAN, ABBY (MS; CCC-SLP)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:ACKERMAN
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 1:2610 ALLEN ST
Mailing Address - Street 2:SUITE 5501
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2500
Mailing Address - Country:US
Mailing Address - Phone:214-243-4934
Mailing Address - Fax:
Practice Address - Street 1:2610 ALLEN ST
Practice Address - Street 2:SUITE 5501
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2500
Practice Address - Country:US
Practice Address - Phone:214-243-4934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101702235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist