Provider Demographics
NPI:1598596454
Name:JEWELL, ABBY ROSE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:ROSE
Last Name:JEWELL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4503 STATE ROUTE 243
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-8831
Mailing Address - Country:US
Mailing Address - Phone:740-532-6898
Mailing Address - Fax:
Practice Address - Street 1:4503 STATE ROUTE 243
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-8831
Practice Address - Country:US
Practice Address - Phone:740-532-6898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.16085235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist