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NPI Code Detail

MEDICARE: ABIGAIL CHARLESWORTH

MEDICARE: ABIGAIL CHARLESWORTH
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 Therapist140893263904UT

General Provider Information

NPI Number : 1942038492
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL CHARLESWORTH
Provider Business Mailing Address
First Line : 530 OAKHOLLOW CT
Second Line :
City : BOUNTIFUL
State : UT
Zip : 84010-3360
Country : US
Telephone Number : 801-671-2496
Fax Number :
Provider Business Practice Location Address
First Line : 481 E 1000 S STE D
Second Line :
City : PLEASANT GROVE
State : UT
Zip : 84062-3716
Country : US
Telephone Number : 801-899-2559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2024
Last Update Date : 07/25/2024

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Directions to “ ABIGAIL CHARLESWORTH ” Practice Location

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