1760905970 NPI number — MRS. ABIGAIL L MCCROMICK-HINOJOSA M.ED, BCABA

Table of content: MRS. ABIGAIL L MCCROMICK-HINOJOSA M.ED, BCABA (NPI 1760905970)

General
Organization/Personal Information
Provider's Other Name Information
NPI Number Information
Provider's Business Mailing Address
Provider's Practice Location Mailing Address
Additional Information
Authorized Official
Provider Taxonomy Codes
Other Provider's Identifiers (legacy, non-NPI)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760905970 NPI number — MRS. ABIGAIL L MCCROMICK-HINOJOSA M.ED, BCABA

Organization/Personal Information

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:
MCCROMICK-HINOJOSA

Provider First Name:
ABIGAIL

Provider Middle Name:
L

Provider Name Prefix Text:
MRS.

Provider Name Suffix Text:

Provider Credential Text:
M.ED, BCABA

Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:
MCCORMICK-HINJOSA

Provider Other First Name:
ABIGAIL

Provider Other Middle Name:
L

Provider Other Name Prefix Text:
MISS

Provider Other Name Suffix Text:

Provider Other Credential Text:
M.ED, BCBA

Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1760905970

Entity Type Code:
Individual

Replacement NPI:

Last Update Date:
11/08/2018

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18521 E. QUEEN CREEK

Provider Second Line Business Mailing Address:
SUITE 105-627

Provider Business Mailing Address City Name:
QUEEN CREEK

Provider Business Mailing Address State Name:
AZ

Provider Business Mailing Address Postal Code:
85142

Provider Business Mailing Address Country Code:
US

Provider Business Mailing Address Telephone Number:
480-361-1025

Provider Business Mailing Address Fax Number:
480-814-7488

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
407 E KING STREET EAST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:
HELENA

Provider Business Practice Location Address State Name:
MT

Provider Business Practice Location Address Postal Code:
59635

Provider Business Practice Location Address Country Code:
US

Provider Business Practice Location Address Telephone Number:
480-361-1025

Provider Business Practice Location Address Fax Number:
480-814-7488

Provider Enumeration Date:
07/19/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

Provider Taxonomy Codes

Taxonomy code: 103K00000X , with the licence number: 1-18-30385 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .