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General NPI Number Information
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NPI Number | 1447036868
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Entity Type | Individual
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Provider Name | DYLAN ABRAMS PHD
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Gender | Male
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Dates
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Enumeration Date | 09/01/2023
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 325 FOUR LEAF LN STE 12
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-9203
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Country | US
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Telephone | 434-202-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 91 10TH ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-2919
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Country | US
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Telephone | 401-595-6226
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0805002488
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS02272
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY10000742
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810008321
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License Number State | VA
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