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NPI 1104631118

NPI 1104631118 : ERICA MARSHALL : TAMPA, FL

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General NPI Number Information
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    NPI Number           |    1104631118
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    Entity Type          |    Individual 
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    Provider Name        |    ERICA MARSHALL
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/08/2025
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    Last Update Date     |    02/08/2025
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Provider Practice Location Address
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    Address Line         |    3109 W DR MARTIN LUTHER KING JR BLVD STE AND501 
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    City                 |    TAMPA
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    State                |    FL
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    Zip                  |    33607-6260
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    Country              |    US
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    Telephone            |    727-431-1986
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1531 SCOTCH PINE DR 
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    City                 |    BRANDON
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    State                |    FL
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    Zip                  |    33511-8309
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    Country              |    US
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    Telephone            |    813-295-5960
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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