Provider Demographics
NPI:1144414137
Name:KIRSCH, ABIGAIL ANN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ANN
Last Name:KIRSCH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:ANN
Other - Last Name:WEGENKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3580 N MOUNT JULIET RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3061
Mailing Address - Country:US
Mailing Address - Phone:615-785-4888
Mailing Address - Fax:
Practice Address - Street 1:3580 N MOUNT JULIET RD
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3061
Practice Address - Country:US
Practice Address - Phone:615-785-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-01
Last Update Date:2007-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3525235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist