Healthcare Provider Details

I. General information

NPI: 1295586261
Provider Name (Legal Business Name): ABIGAIL IRENE PLUFF LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 E 82ND ST
INDIANAPOLIS IN
46250-5538
US

IV. Provider business mailing address

1106 N KEYSTONE AVE
INDIANAPOLIS IN
46201-1368
US

V. Phone/Fax

Practice location:
  • Phone: 317-779-0310
  • Fax:
Mailing address:
  • Phone: 812-870-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33012100A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: