Provider Demographics
NPI:1942853056
Name:BILLINGSLEY, ABIGAIL FORD (RD)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:FORD
Last Name:BILLINGSLEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:8415 BELLONA LN STE 213
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2066
Mailing Address - Country:US
Mailing Address - Phone:410-370-0415
Mailing Address - Fax:
Practice Address - Street 1:8415 BELLONA LN STE 213
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2066
Practice Address - Country:US
Practice Address - Phone:410-370-0415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX4125133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered