Provider Demographics
NPI:1558705426
Name:MOYO, ABIOT (MA, M AR, MDIV)
Entity Type:Individual
Prefix:
First Name:ABIOT
Middle Name:
Last Name:MOYO
Suffix:
Gender:M
Credentials:MA, M AR, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BEACON ST
Mailing Address - Street 2:P.O. BOX 1295
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-3803
Mailing Address - Country:US
Mailing Address - Phone:978-332-6817
Mailing Address - Fax:
Practice Address - Street 1:172 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3750
Practice Address - Country:US
Practice Address - Phone:978-332-6817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor