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General NPI Number Information
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NPI Number | 1013465517
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Entity Type | Individual
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Provider Name | ANDREW SHAFFER BSL
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Gender | Male
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 5351C JAYCEE AVE
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City | HARRISBURG
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State | PA
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Zip | 17112-2997
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Country | US
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Telephone | 717-657-2080
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Fax | 717-657-2290
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Provider Business Mailing Address
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Address Line | 14 COURTLAND RD
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City | CAMP HILL
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State | PA
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Zip | 17011-6609
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Country | US
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Telephone | 717-657-2080
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Fax | 717-657-2290
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | BH002857
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License Number State | PA
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