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General NPI Number Information
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NPI Number | 1710844931
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Entity Type | Individual
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Provider Name | ABIGAIL SUSAN BAGLEY LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 325D KENNEDY MEMORIAL DR
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City | WATERVILLE
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State | ME
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Zip | 04901-4530
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Country | US
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Telephone | 207-616-0499
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Fax |
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Provider Business Mailing Address
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Address Line | 23 NEWPORT RD APT 3
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City | CORINNA
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State | ME
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Zip | 04928-3775
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Country | US
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Telephone | 207-616-1558
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LM25616
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License Number State | ME
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