MEDICARE: DR. ABIGAIL KATHLEEN HASBERRY PHD, MED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1609594571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABIGAIL KATHLEEN HASBERRY PHD, MED

Provider Business Mailing Address
First Line	:	12790 FM 1560 N UNIT 1007
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-2242
Country	:	US
Telephone Number	:	210-870-8688
Fax Number	:

Provider Business Practice Location Address
First Line	:	11303 FAIR HOLLOW DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-3833
Country	:	US
Telephone Number	:	210-870-8688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2022
Last Update Date	:	08/17/2022

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