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NPI Code Detail

MEDICARE: ABIGAIL EILEEN CRADDOCK

MEDICARE: ABIGAIL EILEEN CRADDOCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1619805603
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL EILEEN CRADDOCK
Provider Business Mailing Address
First Line : 2201 MOUNT ZION PKWY
Second Line :
City : MORROW
State : GA
Zip : 30260-3312
Country : US
Telephone Number : 844-543-8437
Fax Number :
Provider Business Practice Location Address
First Line : 2201 MOUNT ZION PKWY
Second Line :
City : MORROW
State : GA
Zip : 30260-3312
Country : US
Telephone Number : 844-543-8437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/11/2026

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Directions to “ ABIGAIL EILEEN CRADDOCK ” Practice Location

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