Healthcare Provider Details

I. General information

NPI: 1235677402
Provider Name (Legal Business Name): ALLISON ABELL LAT, LMT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2017
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 INVERNESS RD
SEVERNA PARK MD
21146-1354
US

IV. Provider business mailing address

274 LAGUNA CIR
SEVERNA PARK MD
21146-1361
US

V. Phone/Fax

Practice location:
  • Phone: 301-395-2063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberA00851
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberM06340
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: