Provider Demographics
NPI:1952988107
Name:MCCLEERY, ABIGAIL (RD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MCCLEERY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:CRAMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:308 N WALLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-4641
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5320 ELLIOTT DR STE 202
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1032
Practice Address - Country:US
Practice Address - Phone:734-712-2851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI954556133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered