Provider Demographics
NPI:1780141978
Name:ABBOTT, CHRISTEN (HAIR LOSS SPECILIST)
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:HAIR LOSS SPECILIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 GARY RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-6216
Mailing Address - Country:US
Mailing Address - Phone:678-732-7981
Mailing Address - Fax:
Practice Address - Street 1:712 GARY RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-6216
Practice Address - Country:US
Practice Address - Phone:678-732-7981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management