Provider Demographics
NPI:1437306156
Name:GREEN, ABIGAIL F (MA)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:F
Last Name:GREEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 DEER TRACKS TRL
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1839
Mailing Address - Country:US
Mailing Address - Phone:314-623-4970
Mailing Address - Fax:
Practice Address - Street 1:1715 DEER TRACKS TRL
Practice Address - Street 2:SUITE 260
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1839
Practice Address - Country:US
Practice Address - Phone:314-623-4970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health