Healthcare Provider Details

I. General information

NPI: 1346023652
Provider Name (Legal Business Name): ABIGAIL PRECIADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 INDUSTRIAL DR STE E
SAINT MARYS GA
31558-4436
US

IV. Provider business mailing address

6816 SOUTHPOINT PKWY STE 500
JACKSONVILLE FL
32216-1702
US

V. Phone/Fax

Practice location:
  • Phone: 912-324-5012
  • Fax:
Mailing address:
  • Phone: 912-324-5012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: