Provider Demographics
NPI:1285100370
Name:EHRLICH, ABIGAIL BROOKE
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:BROOKE
Last Name:EHRLICH
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 1:3800 N HILLS DR APT 307
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2542
Mailing Address - Country:US
Mailing Address - Phone:201-906-7745
Mailing Address - Fax:
Practice Address - Street 1:3800 N HILLS DR APT 307
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-2542
Practice Address - Country:US
Practice Address - Phone:201-906-7745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst