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General NPI Number Information
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NPI Number | 1114370103
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Entity Type | Organization
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Legal Business Name | JAN BLUMENTHAL M.ED,LPC
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 613 VALLEY FORGE RD
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City | WAYNE
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State | PA
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Zip | 19087-3837
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Country | US
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Telephone | 610-246-3051
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Fax |
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Provider Business Mailing Address
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Address Line | 237 E. LANCASTER AVE. SUITE 221
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City | DEVON
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State | PA
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Zip | 19333
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Country | US
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Telephone | 610-246-3051
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JAN BLUMENTHAL
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Credential | M.ED, LPC
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Telephone | 610-246-3051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PC007623
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License Number State | PA
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