Provider Demographics
NPI:1346284312
Name:MCNALLY, ABIGAIL MORIN (PHD)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MORIN
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 HILLIARD ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4922
Mailing Address - Country:US
Mailing Address - Phone:617-492-0750
Mailing Address - Fax:
Practice Address - Street 1:22 HILLIARD ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4922
Practice Address - Country:US
Practice Address - Phone:617-492-0750
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA8239103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW06412OtherBLUE CROSS BLUE SHIELD