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General NPI Number Information
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NPI Number | 1104159953
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Entity Type | Individual
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Provider Name | DAVID MITCHELL KATZ PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 1230 S HURSTBOURNE PKWY STE 245
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City | LOUISVILLE
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State | KY
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Zip | 40222-5797
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Country | US
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Telephone | 502-456-1990
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Fax | 502-473-0667
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Provider Business Mailing Address
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Address Line | 1230 S HURSTBOURNE PKWY STE 245
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City | LOUISVILLE
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State | KY
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Zip | 40222-5797
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Country | US
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Telephone | 502-423-4474
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Fax | 502-423-4471
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1628
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License Number State | KY
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