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NPI Code Detail

MEDICARE: ABIGAIL VAN EGDOM LMFT

MEDICARE: ABIGAIL VAN EGDOM LMFT
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
1106H00000XMarriage & Family Therapist203358TX

General Provider Information

NPI Number : 1639632029
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL VAN EGDOM LMFT
Provider Business Mailing Address
First Line : 7201 METRO BLVD STE 550
Second Line :
City : EDINA
State : MN
Zip : 55439-1353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7201 METRO BLVD STE 550
Second Line :
City : EDINA
State : MN
Zip : 55439-1353
Country : US
Telephone Number : 713-487-5880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2019
Last Update Date : 09/11/2025

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Directions to “ ABIGAIL VAN EGDOM LMFT” Practice Location

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