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NPI 1194057463

NPI 1194057463 : BARBARA E. BLAND, LLC : ELLSWORTH, ME

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General NPI Number Information
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    NPI Number           |    1194057463
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    Entity Type          |    Organization 
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    Legal Business Name  |    BARBARA E. BLAND, LLC 
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Dates
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    Enumeration Date     |    02/11/2010
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    Last Update Date     |    02/11/2010
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Provider Practice Location Address
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    Address Line         |    198 MAIN ST SUITE 9
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    City                 |    ELLSWORTH
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    State                |    ME
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    Zip                  |    04605-1941
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    Country              |    US
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    Telephone            |    207-667-1917
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    Fax                  |    207-667-1814
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Provider Business Mailing Address
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    Address Line         |    29 ORCHARD LN 
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    City                 |    LAMOINE
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    State                |    ME
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    Zip                  |    04605-4464
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    Country              |    US
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    Telephone            |    207-667-1917
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    Fax                  |    207-667-1814
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MS. BARBARA E. BLAND 
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    Credential           |    LCSW
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    Telephone            |    207-667-1917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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