Provider Demographics
NPI:1760905970
Name:MCCROMICK-HINOJOSA, ABIGAIL L (MED, BCABA)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:L
Last Name:MCCROMICK-HINOJOSA
Suffix:
Gender:F
Credentials:MED, BCABA
Other - Prefix:MISS
Other - First Name:ABIGAIL
Other - Middle Name:L
Other - Last Name:MCCORMICK-HINJOSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, BCBA
Mailing Address - Street 1:18521 E. QUEEN CREEK
Mailing Address - Street 2:SUITE 105-627
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142
Mailing Address - Country:US
Mailing Address - Phone:480-361-1025
Mailing Address - Fax:480-814-7488
Practice Address - Street 1:407 E KING STREET EAST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59635
Practice Address - Country:US
Practice Address - Phone:480-361-1025
Practice Address - Fax:480-814-7488
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1-18-30385103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst