Provider Demographics
NPI:1093504961
Name:IVANOVICH, ABIGAIL LEEE (MS ED, CF-SLP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LEEE
Last Name:IVANOVICH
Suffix:
Gender:
Credentials:MS ED, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 1ST AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-6248
Mailing Address - Country:US
Mailing Address - Phone:203-815-5092
Mailing Address - Fax:
Practice Address - Street 1:724 THIMBLE SHOALS BLVD # C
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2574
Practice Address - Country:US
Practice Address - Phone:757-455-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist