Provider Demographics
NPI:1134231723
Name:OVALLE ABUABARA, JUDITH VICTORIA (MD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:VICTORIA
Last Name:OVALLE ABUABARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2310 HOLMES ST
Mailing Address - Street 2:STE 800
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2602
Mailing Address - Country:US
Mailing Address - Phone:816-218-2523
Mailing Address - Fax:816-285-6923
Practice Address - Street 1:106 CORPORATE LAKE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-7170
Practice Address - Country:US
Practice Address - Phone:573-442-1690
Practice Address - Fax:573-442-1804
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010995932084P0804X
MO20110308482084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry