Provider Demographics
NPI:1588189633
Name:HALVORSON, ABBY LYNN (MA, SLP)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:LYNN
Last Name:HALVORSON
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:LYNN
Other - Last Name:PINGREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:715 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-5151
Mailing Address - Country:US
Mailing Address - Phone:605-929-4039
Mailing Address - Fax:
Practice Address - Street 1:315 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:VIBORG
Practice Address - State:SD
Practice Address - Zip Code:57070-2002
Practice Address - Country:US
Practice Address - Phone:605-326-5161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA098912235Z00000X
SD715-PROV235Z00000X
SD808-SLP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist