Provider Demographics
NPI:1164317392
Name:DUFAULT, ABBEGAIL NICHOLE
Entity type:Individual
Prefix:
First Name:ABBEGAIL
Middle Name:NICHOLE
Last Name:DUFAULT
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 1:2915 CLOVER RIDGE DR APT 413
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-4627
Mailing Address - Country:US
Mailing Address - Phone:507-461-0531
Mailing Address - Fax:
Practice Address - Street 1:9382 OAK AVE
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-9422
Practice Address - Country:US
Practice Address - Phone:855-454-2463
Practice Address - Fax:320-295-7898
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor