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General NPI Number Information
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NPI Number | 1033726310
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Entity Type | Individual
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Provider Name | ELIF ANGEL RAYNOR L.M.H.C.
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Gender | Female
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 9900 W SAMPLE RD STE 300
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4077
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Country | US
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Telephone | 954-655-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 3385 NW 79TH AVE
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City | MARGATE
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State | FL
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Zip | 33063-5455
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Country | US
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Telephone | 954-655-2525
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH18411
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License Number State | FL
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