Provider Demographics
NPI:1467333757
Name:FENICLE, ABIGAIL M
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:M
Last Name:FENICLE
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 1:9526 MANY MILE MEWS
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2051
Mailing Address - Country:US
Mailing Address - Phone:301-806-4532
Mailing Address - Fax:
Practice Address - Street 1:9526 MANY MILE MEWS
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2051
Practice Address - Country:US
Practice Address - Phone:301-806-4532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist