Provider Demographics
NPI:1750669727
Name:ABRAMS, DOROTHY EVA (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:EVA
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:DOROTHY
Other - Middle Name:EVA
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:206 CRESCENT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7073
Mailing Address - Country:US
Mailing Address - Phone:662-315-3168
Mailing Address - Fax:
Practice Address - Street 1:4500 I 55 N STE 291
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-5996
Practice Address - Country:US
Practice Address - Phone:601-362-0870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3444235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist