Provider Demographics
NPI:1942684089
Name:HUFFMAN, ABIGAIL (COTA, CLT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:COTA, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 N HIGH DR NW
Mailing Address - Street 2:APT 210
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-2208
Mailing Address - Country:US
Mailing Address - Phone:320-583-2648
Mailing Address - Fax:
Practice Address - Street 1:1555 SHERWOOD ST SE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3285
Practice Address - Country:US
Practice Address - Phone:320-484-6020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN201896224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant