Provider Demographics
NPI:1487274437
Name:ABDAAL, CHANDLER (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHANDLER
Middle Name:
Last Name:ABDAAL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:CHANDLER
Other - Middle Name:
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:3830 ROLLING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-1955
Mailing Address - Country:US
Mailing Address - Phone:248-983-2884
Mailing Address - Fax:
Practice Address - Street 1:3830 ROLLING HILLS DR
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-1955
Practice Address - Country:US
Practice Address - Phone:248-983-2884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
7101007750235Z00000X
MI7151000196235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist