Basic Information
| Provider Information | |||||||||
| NPI: | 1699387936 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIANCHI | ||||||||
| FirstName: | ABIGAIL | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 646 BEDFORD ST APT B8 | ||||||||
| Address2: | |||||||||
| City: | WHITMAN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023821897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8579282249 | ||||||||
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| Practice Location | |||||||||
| Address1: | 76 ACCORD PARK DR | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819230900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2020 | ||||||||
| LastUpdateDate: | 08/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 3142-MH-B1 | MA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.