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General NPI Number Information
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NPI Number | 1043481161
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Entity Type | Individual
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Provider Name | DONNA MAE HARUE DE WIT P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 13432 TULANE STREET
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City | WESTMINSTER
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State | CA
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Zip | 92683-1740
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Country | US
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Telephone | 714-206-6780
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Fax | 714-891-1373
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Provider Business Mailing Address
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Address Line | 13432 TULANE STREET
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City | WESTMINSTER
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State | CA
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Zip | 92683-1740
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Country | US
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Telephone | 714-206-6780
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Fax | 714-891-1373
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT8089
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License Number State | CA
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