Provider Demographics
NPI:1558073676
Name:ALFORD, ABIGAIL RUTH (LPC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:RUTH
Last Name:ALFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11124 MAGIC LN
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-5660
Mailing Address - Country:US
Mailing Address - Phone:214-392-9511
Mailing Address - Fax:
Practice Address - Street 1:1005 W RALPH HALL PKWY STE 201
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6662
Practice Address - Country:US
Practice Address - Phone:469-545-0160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76968101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional