Provider Demographics
NPI:1386117992
Name:PABST, ABIGAIL CHLOE (MT-BC)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:CHLOE
Last Name:PABST
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 SW WOODHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-4079
Mailing Address - Country:US
Mailing Address - Phone:816-214-2720
Mailing Address - Fax:
Practice Address - Street 1:2307 N SAWYER AVE APT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-7999
Practice Address - Country:US
Practice Address - Phone:816-214-2720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
225A00000XOtherMUSIC THERAPIST