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NPI 1184869604

NPI 1184869604 : CARL SIEGEL PHD : WASHINGTON DC, DC

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General NPI Number Information
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    NPI Number           |    1184869604
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    Entity Type          |    Individual 
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    Provider Name        |    CARL SIEGEL PHD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/12/2008
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    Last Update Date     |    12/12/2008
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Provider Practice Location Address
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    Address Line         |    7003 PINEY BRANCH RD. NW 
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    City                 |    WASHINGTON DC
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    State                |    DC
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    Zip                  |    20012
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    Country              |    US
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    Telephone            |    202-449-3789
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    Fax                  |    202-449-3789
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Provider Business Mailing Address
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    Address Line         |    7003 PINEY BRANCH RD. NW 
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    City                 |    WASHINGTON DC
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    State                |    DC
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    Zip                  |    20012
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    Country              |    US
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    Telephone            |    202-449-3789
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    Fax                  |    202-449-3789
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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        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    1649
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    License Number State |    DC
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