Provider Demographics
NPI:1043820046
Name:SIEGWARTH, ABBY SUSAN
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:SUSAN
Last Name:SIEGWARTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6748 E US HIGHWAY 36 UNIT C
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8326
Mailing Address - Country:US
Mailing Address - Phone:317-825-8326
Mailing Address - Fax:
Practice Address - Street 1:6748 E US HIGHWAY 36 UNIT C
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-8326
Practice Address - Country:US
Practice Address - Phone:317-825-8326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist