Healthcare Provider Details

I. General information

NPI: 1932088952
Provider Name (Legal Business Name): DR. ABIGAIL BAKER COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 E HAVERFORD RD STE 301
BRYN MAWR PA
19010-3859
US

IV. Provider business mailing address

630 CATHARINE ST
PHILADELPHIA PA
19147-2937
US

V. Phone/Fax

Practice location:
  • Phone: 610-455-5757
  • Fax:
Mailing address:
  • Phone: 860-659-7502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: