Provider Demographics
NPI:1629214671
Name:ABRAHAM, ARIELLA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ARIELLA
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ARIELLA
Other - Middle Name:
Other - Last Name:ABRAHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:1407 YORK RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6097
Mailing Address - Country:US
Mailing Address - Phone:410-825-2281
Mailing Address - Fax:
Practice Address - Street 1:1407 YORK RD
Practice Address - Street 2:SUITE 310
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6097
Practice Address - Country:US
Practice Address - Phone:410-825-2281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05439103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical