Healthcare Provider Details

I. General information

NPI: 1013841840
Provider Name (Legal Business Name): ABIGAIL LAMOUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 HOLLYWOOD BLVD STE PHE
HOLLYWOOD FL
33021-6760
US

IV. Provider business mailing address

3900 HOLLYWOOD BLVD STE PHE
HOLLYWOOD FL
33021-6760
US

V. Phone/Fax

Practice location:
  • Phone: 954-822-4175
  • Fax:
Mailing address:
  • Phone: 954-822-4175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-542154
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: