Provider Demographics
NPI:1316338635
Name:REA, ABIGAIL (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:REA
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17200 HWY 249
Mailing Address - Street 2:170
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064
Mailing Address - Country:US
Mailing Address - Phone:281-664-6900
Mailing Address - Fax:281-374-1788
Practice Address - Street 1:17200 HWY 249
Practice Address - Street 2:170
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064
Practice Address - Country:US
Practice Address - Phone:281-664-6900
Practice Address - Fax:281-374-1788
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111012235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist