Healthcare Provider Details

I. General information

NPI: 1265361505
Provider Name (Legal Business Name): ABIGAIL LEE QUEEN M.S SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 LOGAN ST STE M
MARION NC
28752-2908
US

IV. Provider business mailing address

5762 BEE TREE AVE
MORGANTON NC
28655-9106
US

V. Phone/Fax

Practice location:
  • Phone: 828-559-2164
  • Fax:
Mailing address:
  • Phone: 828-764-1833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30005083
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: