Provider Demographics
NPI:1689718876
Name:ABDELAL, AHMED M (PHD, CCC)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:M
Last Name:ABDELAL
Suffix:
Gender:M
Credentials:PHD, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 HUNTINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4714
Mailing Address - Country:US
Mailing Address - Phone:508-732-0109
Mailing Address - Fax:508-747-6222
Practice Address - Street 1:27 HUNTINGTON RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4714
Practice Address - Country:US
Practice Address - Phone:508-732-0109
Practice Address - Fax:508-747-6222
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5203235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist