Provider Demographics
NPI:1366291577
Name:TESFAYE, ABIGAIL HALLELUJAH
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:HALLELUJAH
Last Name:TESFAYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 PATAGONIA
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-3108
Mailing Address - Country:US
Mailing Address - Phone:713-679-0472
Mailing Address - Fax:
Practice Address - Street 1:4807 SPICEWOOD SPRINGS RD STE 1140
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8479
Practice Address - Country:US
Practice Address - Phone:512-843-7665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-18
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health