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General NPI Number Information
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NPI Number | 1154654572
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Entity Type | Individual
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Provider Name | BETH D. BAUS M.S.
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Gender | Female
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Dates
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Enumeration Date | 09/16/2009
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Last Update Date | 09/16/2009
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Provider Practice Location Address
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Address Line | 7121 MAGNOLIA AVE SUITE E
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City | RIVERSIDE
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State | CA
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Zip | 92504-3805
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Country | US
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Telephone | 951-682-1153
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Fax | 951-686-5070
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Provider Business Mailing Address
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Address Line | 7121 MAGNOLIA AVE SUITE E
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City | RIVERSIDE
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State | CA
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Zip | 92504-3805
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Country | US
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Telephone | 951-682-1153
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Fax | 951-686-5070
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 47517
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License Number State | CA
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