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General NPI Number Information
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NPI Number | 1538055744
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Entity Type | Individual
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Provider Name | ABIGAIL MERYL MOORE LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 225 FOXBOROUGH BLVD
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City | FOXBOROUGH
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State | MA
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Zip | 02035-3062
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Country | US
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Telephone | 508-901-4685
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Fax |
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Provider Business Mailing Address
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Address Line | 338 CENTRAL ST
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City | MANSFIELD
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State | MA
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Zip | 02048-1358
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Country | US
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Telephone | 401-855-2298
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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 | LCSW230901
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License Number State | MA
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