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General NPI Number Information
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NPI Number | 1083958730
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Entity Type | Individual
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Provider Name | HARRIET MANDELL LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 11/19/2012
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Provider Practice Location Address
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Address Line | 29 S PACA ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1771
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Country | US
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Telephone | 410-328-5719
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Fax | 410-328-2555
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Provider Business Mailing Address
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Address Line | 29 S PACA ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1771
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Country | US
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Telephone | 410-328-5719
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Fax | 410-328-2555
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 04627
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License Number State | MD
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