Provider Demographics
NPI:1376313502
Name:WHITFIELD, ABIGAIL MCKENZIE (RBT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MCKENZIE
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 RUMMELL RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-1709
Mailing Address - Country:US
Mailing Address - Phone:407-335-7116
Mailing Address - Fax:407-960-3009
Practice Address - Street 1:4605 RUMMELL RD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-1709
Practice Address - Country:US
Practice Address - Phone:407-335-7116
Practice Address - Fax:407-960-3009
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-319322106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician