Provider Demographics
NPI:1700807161
Name:ABRAHAM, PAULA A (AUD CCC-A)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:A
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL PKWY STE 303
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4911
Mailing Address - Country:US
Mailing Address - Phone:757-547-9714
Mailing Address - Fax:757-547-0725
Practice Address - Street 1:200 MEDICAL PKWY STE 303
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4911
Practice Address - Country:US
Practice Address - Phone:757-547-9714
Practice Address - Fax:757-547-0725
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201000423231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist