| Abigail Guevara Phd Pc | |
|
16 N Moncoe Rockford MI 49341 | |
| (616) 866-4830 | |
| (616) 866-4944 |
| Full Name | Abigail Guevara Phd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 16 N Moncoe, Rockford, Michigan |
| Authorized Official Name and Position | Abigail Guevara Hansen (PRESIDENT) |
| Authorized Official Contact | 6168664830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abigail Guevara Phd Pc 16 N Moncoe Rockford MI 49341 Ph: (616) 866-4830 | Abigail Guevara Phd Pc 16 N Moncoe Rockford MI 49341 Ph: (616) 866-4830 |
| NPI Number | 1053421818 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 06/21/2016 |
| Medicare PECOS PAC ID | 4385650290 |
|---|---|
| Medicare Enrollment ID | O20060302000149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053421818 | NPI | - | NPPES |
| 11277623 | Other | CAQH | |
| 680DI15940 | Other | BCBS | |
| 162677 | Other | VALUE OPTIONS | |
| 7000023702 | Other | PRIORITY HEALTH | |
| 239038 | Other | UBH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301011335 (Michigan) | Primary |
| Provider Name | Abigail G Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649457987 PECOS PAC ID: 3779540091 Enrollment ID: I20041217000337 |
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