Provider Demographics
NPI:1275035131
Name:ABALKHAIL, MARYAM ABDULLAH
Entity Type:Individual
Prefix:MS
First Name:MARYAM
Middle Name:ABDULLAH
Last Name:ABALKHAIL
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 1:417 LIBERTY STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3736
Mailing Address - Country:US
Mailing Address - Phone:413-747-0705
Mailing Address - Fax:413-732-7075
Practice Address - Street 1:230 MAPLE STREET
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5123
Practice Address - Country:US
Practice Address - Phone:413-532-0389
Practice Address - Fax:413-534-3238
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health