Provider Demographics
NPI:1699432203
Name:LENZ, ABIGAIL CAROLINE
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:CAROLINE
Last Name:LENZ
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 1:8029 ARCTIC FOX RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-4193
Mailing Address - Country:US
Mailing Address - Phone:561-345-1338
Mailing Address - Fax:
Practice Address - Street 1:8029 ARCTIC FOX RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32222-4193
Practice Address - Country:US
Practice Address - Phone:561-345-1338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist