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General NPI Number Information
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NPI Number | 1073200267
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Entity Type | Individual
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Provider Name | SIOBHONN JOB
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Gender | Female
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 12/14/2023
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Provider Practice Location Address
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Address Line | 4850 MARK CENTER DR FL 1
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1882
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Country | US
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Telephone | 703-746-3401
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Fax |
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Provider Business Mailing Address
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Address Line | 2013 H ST NW
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City | WASHINGTON
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State | DC
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Zip | 20006-4201
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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 |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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