Healthcare Provider Details

I. General information

NPI: 1356992838
Provider Name (Legal Business Name): ABIGAIL HOUGH MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 COMO AVE
SAINT PAUL MN
55108-1720
US

IV. Provider business mailing address

464 HOPKINS ST
SAINT PAUL MN
55130-4412
US

V. Phone/Fax

Practice location:
  • Phone: 651-645-5323
  • Fax: 651-641-6190
Mailing address:
  • Phone: 651-263-2699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2217
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: