Provider Demographics
NPI:1952614711
Name:CLOSE, ABAGAIL MARGARET (MS)
Entity Type:Individual
Prefix:MS
First Name:ABAGAIL
Middle Name:MARGARET
Last Name:CLOSE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 COUNTY ROAD 7
Mailing Address - Street 2:
Mailing Address - City:MONTOUR FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14865-9795
Mailing Address - Country:US
Mailing Address - Phone:607-594-6333
Mailing Address - Fax:
Practice Address - Street 1:2723 COUNTY ROAD 7
Practice Address - Street 2:
Practice Address - City:MONTOUR FALLS
Practice Address - State:NY
Practice Address - Zip Code:14865-9795
Practice Address - Country:US
Practice Address - Phone:607-594-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0062471235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist