Provider Demographics
NPI:1558164996
Name:CHAMBERLAIN, ABIGAIL GRACE
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:GRACE
Last Name:CHAMBERLAIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 CENTURY LN
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4286
Mailing Address - Country:US
Mailing Address - Phone:616-396-5284
Mailing Address - Fax:
Practice Address - Street 1:377 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3664
Practice Address - Country:US
Practice Address - Phone:616-396-5284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator