Healthcare Provider Details

I. General information

NPI: 1447165121
Provider Name (Legal Business Name): ABBY NOELLE-MARIE ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 E 13 MILE RD
WARREN MI
48093-3093
US

IV. Provider business mailing address

2545 E WATTLES RD
TROY MI
48085-3627
US

V. Phone/Fax

Practice location:
  • Phone: 586-537-1810
  • Fax:
Mailing address:
  • Phone: 248-519-3379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: