Provider Demographics
NPI:1558056242
Name:MCDANIEL, ABIGAIL (MA, APCC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:MA, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33620 CYCLAMEN LN
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-3428
Mailing Address - Country:US
Mailing Address - Phone:636-667-7519
Mailing Address - Fax:
Practice Address - Street 1:42690 RIO NEDO
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3723
Practice Address - Country:US
Practice Address - Phone:951-365-1518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-07
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12869101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health