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General NPI Number Information
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NPI Number | 1063561645
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Entity Type | Individual
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Provider Name | DIANE JOHNSON FELDER M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 2520 NORTHWINDS PKWY SUITE 300
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City | ALPHARETTA
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State | GA
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Zip | 30009-2216
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Country | US
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Telephone | 678-319-3747
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Fax | 888-656-5712
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Provider Business Mailing Address
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Address Line | 10215 OLIVIA VIEW LN
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City | CYPRESS
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State | TX
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Zip | 77433-4797
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Country | US
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Telephone | 281-451-4327
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | H5122
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | H5122
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License Number State | TX
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