Provider Demographics
NPI:1902673064
Name:THORLEY, ABIGAIL DEAN (MT-BC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:DEAN
Last Name:THORLEY
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:MORGAN
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 JO ANNE CIR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:88 VILCOM CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1660
Practice Address - Country:US
Practice Address - Phone:919-942-2714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
16495225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist