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General NPI Number Information
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NPI Number | 1073893152
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Entity Type | Organization
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Legal Business Name | OPTIMAL SPEECH
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 1079 SNEAD DR
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City | TROY
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State | MI
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Zip | 48085-3316
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Country | US
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Telephone | 248-879-1622
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Fax |
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Provider Business Mailing Address
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Address Line | 1079 SNEAD DR
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City | TROY
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State | MI
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Zip | 48085-3316
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Country | US
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Telephone | 248-879-1622
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAKIKO MIYATANI
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Credential | M.A., CCC-SLP
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Telephone | 248-879-1622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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