Provider Demographics
NPI:1902331036
Name:HAAS, ABIGAIL C (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:C
Last Name:HAAS
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2459
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-6200
Mailing Address - Country:US
Mailing Address - Phone:662-380-5030
Mailing Address - Fax:
Practice Address - Street 1:169 HIGHWAY 6 E STE 102
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-6902
Practice Address - Country:US
Practice Address - Phone:662-380-5030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3976235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist