Provider Demographics
NPI:1720562267
Name:DUFRETAY-STEPANEK, ABIGAIL E
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:E
Last Name:DUFRETAY-STEPANEK
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 1:1305 BLACKBERRY LN
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-9662
Mailing Address - Country:US
Mailing Address - Phone:626-437-8565
Mailing Address - Fax:
Practice Address - Street 1:1305 BLACKBERRY LN
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-9662
Practice Address - Country:US
Practice Address - Phone:626-437-8565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0104961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical