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General NPI Number Information
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NPI Number | 1174095400
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Entity Type | Organization
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Legal Business Name | THERAPIES UNITED
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Dates
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Enumeration Date | 12/27/2018
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 301 S 2ND ST
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City | CHICKASHA
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State | OK
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Zip | 73018-3600
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Country | US
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Telephone | 405-574-6836
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Fax | 405-825-3290
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Provider Business Mailing Address
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Address Line | 1814 PARK AVE
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City | CHICKASHA
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State | OK
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Zip | 73018-6345
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Country | US
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Telephone | 140-557-4683
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | AMANDA LYNN PAUL
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Credential | MS,CCC-SLP
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Telephone | 405-574-6836
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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 |
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License Number State |
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