Provider Demographics
NPI:1700268752
Name:EASTMAN, ABIGAEL DAVINA
Entity type:Individual
Prefix:
First Name:ABIGAEL
Middle Name:DAVINA
Last Name:EASTMAN
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 1:293 STARK HWY N
Mailing Address - Street 2:
Mailing Address - City:DUNBARTON
Mailing Address - State:NH
Mailing Address - Zip Code:03046-4715
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:293 STARK HWY N
Practice Address - Street 2:
Practice Address - City:DUNBARTON
Practice Address - State:NH
Practice Address - Zip Code:03046-4715
Practice Address - Country:US
Practice Address - Phone:603-229-7260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-26
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health