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General NPI Number Information
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NPI Number | 1073109880
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Entity Type | Organization
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Legal Business Name | VAST GROWTH
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Dates
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Enumeration Date | 12/15/2020
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 580 LEONARD AVE
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City | UNIONDALE
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State | NY
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Zip | 11553-2524
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Country | US
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Telephone | 516-289-2574
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 436
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City | UNIONDALE
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State | NY
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Zip | 11553-0436
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | LATESHA RANDELL COPELAND
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Credential |
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Telephone | 516-289-2574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171R00000X
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Taxonomy Name | Interpreter
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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 | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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