Provider Demographics
NPI:1629705579
Name:HENTZ, ABIGAIL JEANNE
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:JEANNE
Last Name:HENTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 OAK ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2505
Mailing Address - Country:US
Mailing Address - Phone:513-606-5007
Mailing Address - Fax:
Practice Address - Street 1:400 OAK ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2505
Practice Address - Country:US
Practice Address - Phone:513-606-5007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator