Healthcare Provider Details

I. General information

NPI: 1568302750
Provider Name (Legal Business Name): ABIGAIL CONWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 E NORTHFIELD DR
BROWNSBURG IN
46112-2420
US

IV. Provider business mailing address

622 S FULLER DR
INDIANAPOLIS IN
46241-2232
US

V. Phone/Fax

Practice location:
  • Phone: 317-960-3135
  • Fax:
Mailing address:
  • Phone:
  • 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: