Provider Demographics
NPI:1457033169
Name:WINCHESTER, ABIGAIL RUTH (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:RUTH
Last Name:WINCHESTER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:MS
Other - First Name:ABIGAIL
Other - Middle Name:RUTH
Other - Last Name:MONTGOMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5446 ANDREA ST
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-3253
Mailing Address - Country:US
Mailing Address - Phone:903-821-4251
Mailing Address - Fax:
Practice Address - Street 1:951 N WASHINGTON AVE BLDG 4
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2194
Practice Address - Country:US
Practice Address - Phone:321-268-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT24306225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist