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General NPI Number Information
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NPI Number | 1053586925
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Entity Type | Organization
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Legal Business Name | JILL HAZZARD M.A. L.M.H.C, INC
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 7269 BEE RIDGE RD
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City | SARASOTA
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State | FL
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Zip | 34241-5969
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Country | US
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Telephone | 941-504-0770
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Fax | 941-342-1295
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Provider Business Mailing Address
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Address Line | 6541 MYAKKA VALLEY TRL
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City | SARASOTA
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State | FL
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Zip | 34241-9671
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Country | US
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Telephone | 941-504-0770
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JILL HAZZARD
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Credential | M.A. LMHC
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Telephone | 941-504-0770
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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 | MH4908
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License Number State | FL
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