Individual
ABIGAIL NICOLE FANGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6330 NW KELLY DR, PARKVILLE, MO 64152-4024
(816) 469-5162
Mailing address
815 N HEMLOCK ST, OTTAWA, KS 66067-1655
(785) 248-3357
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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