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NPI 1003381294

NPI 1003381294 : WINDY STIWALD : FAIRLAWN, OH

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General NPI Number Information
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    NPI Number           |    1003381294
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    Entity Type          |    Individual 
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    Provider Name        |    WINDY STIWALD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/04/2018
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    Last Update Date     |    09/29/2020
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Provider Practice Location Address
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    Address Line         |    3428 W MARKET ST 
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    City                 |    FAIRLAWN
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    State                |    OH
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    Zip                  |    44333-3339
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    Country              |    US
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    Telephone            |    330-668-4041
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    25150 WOLF RD 
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    City                 |    BAY VILLAGE
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    State                |    OH
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    Zip                  |    44140-2658
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    Country              |    US
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    Telephone            |    740-973-2416
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    
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    License Number State |    
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