Provider Demographics
NPI:1740069046
Name:BROMS, ABIGAIL (MA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:BROMS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:
Other - Last Name:BROMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:13475 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-3260
Mailing Address - Country:US
Mailing Address - Phone:678-662-3245
Mailing Address - Fax:
Practice Address - Street 1:738 WOODLAWN DR NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4253
Practice Address - Country:US
Practice Address - Phone:770-726-9589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional