Healthcare Provider Details

I. General information

NPI: 1316631278
Provider Name (Legal Business Name): CONNOR CHRISTIAN ABELL M.A. CF-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 POPLAR
SCHOOLCRAFT MI
49087-8747
US

IV. Provider business mailing address

701 POPLAR
SCHOOLCRAFT MI
49087-8747
US

V. Phone/Fax

Practice location:
  • Phone: 269-329-8945
  • Fax:
Mailing address:
  • Phone: 269-329-8945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: