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General NPI Number Information
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NPI Number | 1053526517
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Entity Type | Individual
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Provider Name | KIMBERLY MARIE SKRUM HEAL MSCCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 901 MULBERRY ST
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City | LAKE MILLS
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State | WI
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Zip | 53551-1335
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Country | US
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Telephone | 608-648-3144
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Fax |
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Provider Business Mailing Address
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Address Line | N3269 HOOKER RD.
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City | POYNETTE
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State | WI
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Zip | 53955-9257
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Country | US
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Telephone | 608-635-2807
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2376-154
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License Number State | WI
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