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General NPI Number Information
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NPI Number | 1063167344
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Entity Type | Individual
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Provider Name | MONIKA MONTECILLO LPC
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Gender | Female
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 1436 BRAIDED ROPE DR
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City | AUSTIN
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State | TX
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Zip | 78727-4622
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Country | US
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Telephone | 512-923-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 1464 E WHITESTONE BLVD STE 2001
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City | CEDAR PARK
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State | TX
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Zip | 78613-9078
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Country | US
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Telephone | 512-923-9900
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 75531
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License Number State | TX
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