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General NPI Number Information
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NPI Number | 1033916903
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Entity Type | Organization
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Legal Business Name | MAGIC THERAPY LLC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | CARR. 153 CENTRO RODAL A1 KM 9.6
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-664-4884
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2061
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City | COAMO
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State | PR
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Zip | 00769-4061
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Country | US
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Telephone | 787-664-4884
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MYLEISHKA TORRES AGOSTO
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Credential |
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Telephone | 787-205-7782
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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