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General NPI Number Information
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NPI Number | 1073740312
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Entity Type | Individual
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Provider Name | MIGDALIA Q LEMARQUE LMHC, IMT
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Gender | Female
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Dates
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Enumeration Date | 06/14/2009
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 9951 ATLANTIC BLVD SUITE 317-1
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City | JACKSONVILLE
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State | FL
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Zip | 32225-6584
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Country | US
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Telephone | 904-722-8077
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Fax | 904-722-8077
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Provider Business Mailing Address
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Address Line | 12301 APPLE LEAF DR
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City | JACKSONVILLE
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State | FL
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Zip | 32224-6631
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Country | US
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Telephone | 904-535-4243
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Fax | 904-998-8242
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH9791
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMT1041
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License Number State | FL
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