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General NPI Number Information
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NPI Number | 1205563574
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Entity Type | Individual
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Provider Name | ABIGAIL JEAN BROWN
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Gender | Female
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 601 S CENTER AVE
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City | MERRILL
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State | WI
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Zip | 54452-3404
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Country | US
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Telephone | 715-539-2466
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 W JACKSON ST APT 59
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City | MERRILL
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State | WI
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Zip | 54452-4201
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Country | US
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Telephone | 715-663-0211
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 6030-154
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License Number State | WI
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