| Doctor Name: | ANGELA ABBOTT |
| NPI Number: | 1053777078 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, ATR |
| License Number: | 18749 |
| Business Practice Address: | 2435 E Southlake Blvd Suite 100 Southlake, TX - 760926678 |
| Business Phone Number: | 8178122880 |
| Business Fax Number: | |
| Mailing Address: | 2435 E Southlake Blvd, Suite 100 SOUTHLAKE |
| State: | TX |
| Postal Code: | 760926678 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/06/2016 |
| NPI Last Update Date: | 01/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 18749 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |