Healthcare Provider Details

I. General information

NPI: 1013353531
Provider Name (Legal Business Name): ABIGAIL MINTZ ROMIROWSKY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ABIGAIL DIANA MINTZ

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 11/29/2024
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 CONNECTICUT AVE NW UNIT 104
WASHINGTON DC
20008
US

IV. Provider business mailing address

2317 ONTARIO RD NW
WASHINGTON DC
20009
US

V. Phone/Fax

Practice location:
  • Phone: 202-505-1865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number05113
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1000932
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: