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General NPI Number Information
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NPI Number | 1164769451
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Entity Type | Organization
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Legal Business Name | PHOENIX THERAPY SERVICES, PLLC
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 3213 STUMP LAKE DR
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City | MONROE
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State | NC
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Zip | 28110-8798
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Country | US
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Telephone | 704-282-0818
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Fax | 704-635-8353
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Provider Business Mailing Address
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Address Line | PO BOX 3032
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City | MONROE
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State | NC
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Zip | 28111-3032
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Country | US
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Telephone | 704-282-0818
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Fax | 704-635-8353
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | MRS. ANGELA CATHERINE FINK
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Credential | OTR/L
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Telephone | 704-282-0818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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