Provider Demographics
NPI:1962187013
Name:MAHER, ABIGAIL JEAN (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:JEAN
Last Name:MAHER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:BOCKHAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1860 WOOD DUCK CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-4773
Mailing Address - Country:US
Mailing Address - Phone:515-249-2123
Mailing Address - Fax:
Practice Address - Street 1:1860 WOOD DUCK CT
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-4773
Practice Address - Country:US
Practice Address - Phone:515-249-2123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14069497235Z00000X
IA115947235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist