Provider Demographics
NPI:1831871524
Name:ABELL, AUDREY LYNN
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:LYNN
Last Name:ABELL
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 1:5236 COLUMBIA DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2368
Mailing Address - Country:US
Mailing Address - Phone:979-942-6250
Mailing Address - Fax:
Practice Address - Street 1:11653 GALM RD BLDG 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-9506
Practice Address - Country:US
Practice Address - Phone:210-446-6454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79916101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional