Provider Demographics
NPI:1679697080
Name:NGUYEN, ABIGAIL C (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:C
Last Name:NGUYEN
Suffix:
Gender:
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11012 KNIGHT CASTLE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0212
Mailing Address - Country:US
Mailing Address - Phone:919-244-8396
Mailing Address - Fax:
Practice Address - Street 1:11012 KNIGHT CASTLE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-0212
Practice Address - Country:US
Practice Address - Phone:704-251-9112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12627225X00000X, 225XP0200X
SC5900225X00000X
NC6826225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8920753 00Medicaid