Provider Demographics
NPI:1043610694
Name:RITCHIE, ABIGAIL (PSYD)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2919 W SWANN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4050
Mailing Address - Country:US
Mailing Address - Phone:404-395-2374
Mailing Address - Fax:
Practice Address - Street 1:2919 W SWANN AVE STE 201
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4050
Practice Address - Country:US
Practice Address - Phone:404-395-2374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9120103G00000X, 103TC0700X
CO4084103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical