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General NPI Number Information
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NPI Number | 1174422729
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Entity Type | Individual
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Provider Name | NICOLE BERNARD MS,LBS
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Gender | Female
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 518 S CORTINA CT
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City | HENRYVILLE
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State | PA
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Zip | 18332-7720
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Country | US
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Telephone | 570-688-8086
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Fax |
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Provider Business Mailing Address
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Address Line | 518 S CORTINA CT
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City | HENRYVILLE
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State | PA
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Zip | 18332-7720
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Country | US
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Telephone |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH007993
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License Number State | PA
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