Provider Demographics
NPI:1477399632
Name:ABRAMS, INDIA
Entity type:Individual
Prefix:
First Name:INDIA
Middle Name:
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KANESIA
Other - Middle Name:MICHELLE
Other - Last Name:EATON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CCMA
Mailing Address - Street 1:606 S CRAFT HWY
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36617-3606
Mailing Address - Country:US
Mailing Address - Phone:251-501-0996
Mailing Address - Fax:
Practice Address - Street 1:750 DOWNTOWNER LOOP W STE H163
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5528
Practice Address - Country:US
Practice Address - Phone:251-386-2289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-06
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALN5L2C9Z71041C0700X
ALC6T9Q3Y51041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL993717287OtherMOBILE PHLEBOTOMY SERVICES