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General NPI Number Information
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NPI Number | 1144020561
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Entity Type | Individual
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Provider Name | DEIDRE NAOMI GILYARD MS
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Gender | Female
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 365 W PASSAIC ST STE 115
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3015
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Country | US
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Telephone | 201-265-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 608 7TH ST APT 2
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City | CARLSTADT
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State | NJ
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Zip | 07072-1715
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Country | US
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Telephone | 201-546-2573
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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