Provider Demographics
NPI:1194315895
Name:TAYLOR-TROUT, ABIGAIL MARIE
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MARIE
Last Name:TAYLOR-TROUT
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 1:500 ORCHARD AVE # C101
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1812
Mailing Address - Country:US
Mailing Address - Phone:484-748-4881
Mailing Address - Fax:
Practice Address - Street 1:500 ORCHARD AVE # C101
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1812
Practice Address - Country:US
Practice Address - Phone:484-748-4881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020262103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical