| Katie Abdalla | |
|
810 Chester River Dr Grasonville MD 21638-1004 | |
| (410) 739-7705 | |
| Not Available |
| Full Name | Katie Abdalla |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 810 Chester River Dr, Grasonville, Maryland |
| Authorized Official Name and Position | Katie Lynn Abdalla (CLINICAL THERAPIST) |
| Authorized Official Contact | 4107397705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katie Abdalla 810 Chester River Dr Grasonville MD 21638-1004 Ph: (410) 739-7705 | Katie Abdalla 810 Chester River Dr Grasonville MD 21638-1004 Ph: (410) 739-7705 |
| NPI Number | 1679395602 |
|---|---|
| Provider Enumeration Date | 10/30/2024 |
| Last Update Date | 01/02/2025 |
| Certification Date | 01/02/2025 |
| Medicare PECOS PAC ID | 6103355003 |
|---|---|
| Medicare Enrollment ID | O20250122001224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679395602 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Katie L Abdalla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891298063 PECOS PAC ID: 9537586490 Enrollment ID: I20200825000079 |
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