Healthcare Provider Details

I. General information

NPI: 1558232579
Provider Name (Legal Business Name): ABIGAIL KIRKLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 MARGIE DR
WARNER ROBINS GA
31088-7818
US

IV. Provider business mailing address

311 MARGIE DR
WARNER ROBINS GA
31088-7818
US

V. Phone/Fax

Practice location:
  • Phone: 404-410-7600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2825829
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: