Individual
ABAGAIL ROSE WAIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
18700 OXNARD ST, TARZANA, CA 91356-1413
(818) 654-3950
Mailing address
6200 DE SOTO AVE APT 35307, WOODLAND HILLS, CA 91367-0204
(215) 285-9998
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MXD840427499
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/08/2019
Last updated
05/08/2019
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