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NPI 1073009411

NPI 1073009411 : DEBANIA ALFREDA CHRISTIE C.L.M.T. : DENVER, CO

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General NPI Number Information
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    NPI Number           |    1073009411
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    Entity Type          |    Individual 
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    Provider Name        |    DEBANIA ALFREDA CHRISTIE C.L.M.T.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/09/2018
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    Last Update Date     |    06/11/2019
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Provider Practice Location Address
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    Address Line         |    3000 S JAMAICA CT STE 250 
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    City                 |    DENVER
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    State                |    CO
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    Zip                  |    80014-4605
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    Country              |    US
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    Telephone            |    720-688-0293
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    705 S ALTON WAY UNIT 1A 
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    City                 |    DENVER
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    State                |    CO
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    Zip                  |    80247-1803
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    Country              |    US
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    Telephone            |    720-209-8774
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    MT.0017906
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    License Number State |    CO
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