Provider Demographics
NPI:1306171988
Name:BLAIR, ABIGAIL HOGAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:HOGAN
Last Name:BLAIR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 WOODLAND VLG
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1150
Mailing Address - Country:US
Mailing Address - Phone:205-370-1235
Mailing Address - Fax:
Practice Address - Street 1:1205 WOODLAND VLG
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-1150
Practice Address - Country:US
Practice Address - Phone:205-370-1235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2258G104100000X
AL2302C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker