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General NPI Number Information
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NPI Number | 1003337254
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Entity Type | Individual
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Provider Name | JUNE MITSUNAGA FUJIMOTO MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 06/28/2017
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Provider Practice Location Address
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Address Line | 1968 W ADAMS BLVD STE 300
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City | LOS ANGELES
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State | CA
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Zip | 90018-3515
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Country | US
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Telephone | 310-553-3695
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Fax |
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Provider Business Mailing Address
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Address Line | 2570 W 235TH ST APT 3
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City | TORRANCE
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State | CA
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Zip | 90505-4259
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Country | US
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Telephone | 310-508-6015
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 4682
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License Number State | CA
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