Provider Demographics
NPI:1609239706
Name:ABRAHAM, JANICE
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3188 S BUD LN
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-6207
Mailing Address - Country:US
Mailing Address - Phone:972-467-2162
Mailing Address - Fax:
Practice Address - Street 1:3188 S BUD LN
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-6207
Practice Address - Country:US
Practice Address - Phone:972-467-2162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73391101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health