Provider Demographics
NPI:1962110478
Name:SOENTGERATH, ABIGAIL LOUISA (SLP-CCC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LOUISA
Last Name:SOENTGERATH
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-3707
Mailing Address - Country:US
Mailing Address - Phone:912-245-1068
Mailing Address - Fax:
Practice Address - Street 1:1988 HAIRE RD
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-8807
Practice Address - Country:US
Practice Address - Phone:803-548-9113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7784235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty