Healthcare Provider Details

I. General information

NPI: 1780419101
Provider Name (Legal Business Name): ABIGAIL LEIGH PRYOR MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 CAHILL RD
BRANSON MO
65616-2036
US

IV. Provider business mailing address

8602 HIGHWAY 65 S
CLINTON AR
72031-8599
US

V. Phone/Fax

Practice location:
  • Phone: 417-335-7274
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.018209
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number242.008044
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2025035725
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: