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General NPI Number Information
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NPI Number | 1013843606
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Entity Type | Individual
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Provider Name | MS. NICOLETTE S FIELDS
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Gender | Female
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 2301 S BROADWAY AVE STE B10
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City | TYLER
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State | TX
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Zip | 75701-5409
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Country | US
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Telephone | 903-884-7500
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Fax | 903-884-7499
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Provider Business Mailing Address
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Address Line | 2301 S BROADWAY AVE STE B10
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City | TYLER
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State | TX
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Zip | 75701-5409
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Country | US
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Telephone | 903-884-7500
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Fax | 903-884-7499
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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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