Individual
ABIGAIL RUTH CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
217 STATION ST, JACKSONVILLE, NC 28546-6304
(910) 378-2501
Mailing address
411 MAPLE ST, JACKSONVILLE, NC 28540-4916
(217) 357-7487
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
000048620079
NC
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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