Provider Demographics
NPI:1508484296
Name:ABBATH, HILARY CHRISTINE (LCMT)
Entity Type:Individual
Prefix:MISS
First Name:HILARY
Middle Name:CHRISTINE
Last Name:ABBATH
Suffix:
Gender:F
Credentials:LCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 55TH AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2955
Mailing Address - Country:US
Mailing Address - Phone:970-397-7164
Mailing Address - Fax:
Practice Address - Street 1:3211 W 20TH ST STE D
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6566
Practice Address - Country:US
Practice Address - Phone:970-397-7164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0001999225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist