Healthcare Provider Details

I. General information

NPI: 1255267654
Provider Name (Legal Business Name): ABIGAIL KATHLEEN RODA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 BETHLEHEM PIKE # B
ERDENHEIM PA
19038-8116
US

IV. Provider business mailing address

1840 CREEK RUN LN
LEBANON PA
17042-6442
US

V. Phone/Fax

Practice location:
  • Phone: 215-385-5122
  • Fax: 267-787-1148
Mailing address:
  • Phone: 717-376-9449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW141245
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: