Provider Demographics
NPI:1962515916
Name:CONNELL, ABBY C (AUD)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:C
Last Name:CONNELL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ABBY
Other - Middle Name:C
Other - Last Name:TURICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1543 ASHLEY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5201
Mailing Address - Country:US
Mailing Address - Phone:843-556-4327
Mailing Address - Fax:843-556-2171
Practice Address - Street 1:1543 ASHLEY RIVER RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5201
Practice Address - Country:US
Practice Address - Phone:843-556-4327
Practice Address - Fax:843-556-2171
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3328231H00000X
SC231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA0458Medicaid
SCSA0458Medicaid
SC5449Medicare UPIN