Provider Demographics
NPI:1316798911
Name:MCCOY, ABBIGAEL ROSE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ABBIGAEL
Middle Name:ROSE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ABBIGAEL
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:635 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:VA
Mailing Address - Zip Code:24266-3809
Mailing Address - Country:US
Mailing Address - Phone:276-415-9880
Mailing Address - Fax:
Practice Address - Street 1:635 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266-3809
Practice Address - Country:US
Practice Address - Phone:276-415-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist