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General NPI Number Information
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NPI Number | 1134540495
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Entity Type | Organization
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Legal Business Name | SUSAN M. COHEN, PSY.D. LLC
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Dates
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Enumeration Date | 01/03/2014
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 577 PAMAELE ST
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City | KAILUA
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State | HI
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Zip | 96734-3529
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Country | US
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Telephone | 808-262-5335
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Fax | 808-230-2132
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Provider Business Mailing Address
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Address Line | 577 PAMAELE ST
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City | KAILUA
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State | HI
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Zip | 96734-3529
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Country | US
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Telephone | 808-262-5335
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Fax | 808-230-2132
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN M COHEN
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Credential | PSY.D.
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Telephone | 808-262-5335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY742
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License Number State | HI
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