Provider Demographics
NPI:1134795420
Name:LEBBIE, ABIGAIL SONIA
Entity type:Individual
Prefix:
First Name:ABIGAIL SONIA
Middle Name:
Last Name:LEBBIE
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 1:5601 PAYNES ENDEAVOR DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3380
Mailing Address - Country:US
Mailing Address - Phone:240-470-4419
Mailing Address - Fax:
Practice Address - Street 1:7729 HUBBLE DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2498
Practice Address - Country:US
Practice Address - Phone:301-328-6151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA0063102253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care