Provider Demographics
NPI:1023999885
Name:CHAVEZ, ABIGAIL L (LMT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:L
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4623 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6115
Mailing Address - Country:US
Mailing Address - Phone:513-253-7297
Mailing Address - Fax:
Practice Address - Street 1:10547 MONTGOMERY RD STE 500
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4462
Practice Address - Country:US
Practice Address - Phone:513-496-3939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.026669225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist