Provider Demographics
NPI:1922640606
Name:BURTON, ABIGAIL
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:BURTON
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 1:13220 CHESTNUT OAK DR
Mailing Address - Street 2:
Mailing Address - City:DARNESTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3553
Mailing Address - Country:US
Mailing Address - Phone:619-392-4807
Mailing Address - Fax:
Practice Address - Street 1:3717 DECATUR AVE STE 1
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2148
Practice Address - Country:US
Practice Address - Phone:202-594-8742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist