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General NPI Number Information
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NPI Number | 1013343532
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Entity Type | Individual
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Provider Name | JULIE SUZANNE O'DONNELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 509 CASCADE AVE STE A
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City | HOOD RIVER
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State | OR
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Zip | 97031-2060
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Country | US
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Telephone | 971-404-6504
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 644
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City | MOSIER
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State | OR
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Zip | 97040-0644
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Country | US
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Telephone | 971-404-6504
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L6408
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License Number State | OR
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