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General NPI Number Information
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NPI Number | 1194126367
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Entity Type | Individual
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Provider Name | ABBEY VANDERMILLION LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/08/2014
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 90 E SOUTHBROOK CT
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City | COLUMBIA
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State | MO
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Zip | 65203-8627
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Country | US
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Telephone | 573-200-6518
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Fax |
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Provider Business Mailing Address
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Address Line | 90 E SOUTHBROOK CT
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City | COLUMBIA
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State | MO
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Zip | 65203-8627
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Country | US
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Telephone | 573-200-6518
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2016044085
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License Number State | MO
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