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General NPI Number Information
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NPI Number | 1194011767
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Entity Type | Individual
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Provider Name | ANDREA C ROSALES MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 1604 SPRING HILL RD FL 3
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City | VIENNA
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State | VA
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Zip | 22182-7510
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Country | US
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Telephone | 703-546-8594
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Fax | 212-679-7868
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Provider Business Mailing Address
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Address Line | 950 25TH ST NW APT 815N
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City | WASHINGTON
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State | DC
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Zip | 20037-2176
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Country | US
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Telephone | 305-582-6251
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202006358
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License Number State | VA
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