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General NPI Number Information
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NPI Number | 1134713563
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Entity Type | Individual
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Provider Name | AERIELLE SANTOR CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 5401 FOUNTAIN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90029-1006
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Country | US
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Telephone | 323-465-2106
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Fax |
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Provider Business Mailing Address
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Address Line | 10528 WILLOWBRAE AVE
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City | CHATSWORTH
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State | CA
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Zip | 91311-2257
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Country | US
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Telephone | 818-625-7530
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 15482
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License Number State | CA
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