Healthcare Provider Details

I. General information

NPI: 1457090763
Provider Name (Legal Business Name): ABIGAIL MARIE RANSCHAU M.A. CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2022
Last Update Date: 06/03/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5406 MERLE HAY RD
JOHNSTON IA
50131-1209
US

IV. Provider business mailing address

1018 NW LEXI LN
WAUKEE IA
50263-1020
US

V. Phone/Fax

Practice location:
  • Phone: 515-727-8750
  • Fax:
Mailing address:
  • Phone: 319-929-7591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number114789
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: