Provider Demographics
NPI:1205171972
Name:BUNT, ABIGAIL RYAN (BCBA)
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:RYAN
Last Name:BUNT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3110 CAMINO DEL RIO S STE 307
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3832
Mailing Address - Country:US
Mailing Address - Phone:619-795-9925
Mailing Address - Fax:877-602-5087
Practice Address - Street 1:3110 CAMINO DEL RIO S STE 307
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3832
Practice Address - Country:US
Practice Address - Phone:619-795-9925
Practice Address - Fax:877-602-5087
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst