Provider Demographics
NPI:1477088748
Name:HICKLING, ABIGAIL (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:HICKLING
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:32 CHESTNUT RD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-2604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 HALLWOOD RD STE D
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1982
Practice Address - Country:US
Practice Address - Phone:518-526-3124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028385-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist