Provider Demographics
NPI:1861108805
Name:SMITH, ABIGAYLE CHRISTINE JANE (RBT)
Entity type:Individual
Prefix:MISS
First Name:ABIGAYLE
Middle Name:CHRISTINE JANE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:311 1ST AVE S STE 11
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-4277
Mailing Address - Country:US
Mailing Address - Phone:701-952-3500
Mailing Address - Fax:
Practice Address - Street 1:311 1ST AVE S STE 11
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-4277
Practice Address - Country:US
Practice Address - Phone:701-952-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRBT-23255317106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician