Provider Demographics
NPI:1750808457
Name:STAUFFER, ABIGAIL R (MSW LSW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:R
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:MSW LSW
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:R
Other - Last Name:HOHIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LSW
Mailing Address - Street 1:2685 ARMSTRONG RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-9041
Mailing Address - Country:US
Mailing Address - Phone:330-345-7949
Mailing Address - Fax:
Practice Address - Street 1:2685 ARMSTRONG RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-9041
Practice Address - Country:US
Practice Address - Phone:330-345-7949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OHS1701574104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator