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General NPI Number Information
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NPI Number | 1174797187
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Entity Type | Individual
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Provider Name | CHAROLETTE LIPPOLIS CONDON DO
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Gender | Female
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 7550 W YALE AVE STE A155
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City | LAKEWOOD
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State | CO
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Zip | 80227-3476
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Country | US
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Telephone | 720-980-2479
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 86
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City | EVERGREEN
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State | CO
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Zip | 80437-0086
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Country | US
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Telephone | 720-984-2679
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Fax | 888-344-0395
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 45886
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License Number State | CO
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