Provider Demographics
NPI:1811752264
Name:HINES, ABIGAIL TASHIKA
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:TASHIKA
Last Name:HINES
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 1:423 VALOR CIR
Mailing Address - Street 2:
Mailing Address - City:FORT GREGG ADAMS
Mailing Address - State:VA
Mailing Address - Zip Code:23801-1066
Mailing Address - Country:US
Mailing Address - Phone:706-527-6185
Mailing Address - Fax:
Practice Address - Street 1:423 VALOR CIR
Practice Address - Street 2:
Practice Address - City:FORT GREGG ADAMS
Practice Address - State:VA
Practice Address - Zip Code:23801-1066
Practice Address - Country:US
Practice Address - Phone:706-527-6185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional