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General NPI Number Information
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NPI Number | 1063144624
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Entity Type | Organization
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Legal Business Name | N.U. VISION
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 702 JAMES ST
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City | TIMMONSVILLE
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State | SC
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Zip | 29161-1600
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Country | US
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Telephone | 678-993-5881
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Fax |
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Provider Business Mailing Address
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Address Line | 702 JAMES ST
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City | TIMMONSVILLE
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State | SC
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Zip | 29161-1600
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Country | US
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Telephone | 678-993-5881
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Fax |
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | PROF. LA'DEA MIRANDA WRIGHT
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Credential | THERAPIST
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Telephone | 678-993-5881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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