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Individual

ABBY NORDQUIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.MFT, LMFT

Contact information

Practice address
4317 E GENESEE ST STE 202, SYRACUSE, NY 13214-2114
(315) 552-1598
(315) 254-2852
Mailing address
4317 E GENESEE ST STE 202, SYRACUSE, NY 13214-2114
(315) 552-1598
(315) 254-2852

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001186
NY
106H00000X
Marriage & Family Therapist
0763
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000733194
ANTHEM
Enumeration date
02/07/2011
Last updated
03/17/2018
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