Provider Demographics
NPI:1821507971
Name:ABRAHAM, LOYDA
Entity Type:Individual
Prefix:
First Name:LOYDA
Middle Name:
Last Name:ABRAHAM
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 1:8944 NW 117TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4145
Mailing Address - Country:US
Mailing Address - Phone:786-970-5412
Mailing Address - Fax:
Practice Address - Street 1:8944 NW 117 TERRACE
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDEN
Practice Address - State:FL
Practice Address - Zip Code:33018-4145
Practice Address - Country:US
Practice Address - Phone:786-970-5412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician