Organization
ABIGAIL GUEVARA PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABIGAIL GUEVARA HANSEN PHD (PRESIDENT)
(616) 866-4830
Entity
Organization
Contact information
Practice address
16 N MONCOE, ROCKFORD, MI 49341
(616) 866-4830
(616) 866-4944
Mailing address
16 N MONCOE, ROCKFORD, MI 49341
(616) 866-4830
(616) 866-4944
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301011335
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11277623
CAQH
—
01
—
162677
VALUE OPTIONS
—
01
—
239038
UBH
—
01
—
680DI15940
BCBS
—
01
—
7000023702
PRIORITY HEALTH
—
Enumeration date
08/30/2006
Last updated
06/21/2016
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