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General NPI Number Information
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NPI Number | 1194242057
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Entity Type | Individual
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Provider Name | STEFANIE ALLAN
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Gender | Female
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 480 CENTRAL AVE
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City | PEARL HARBOR
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State | HI
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Zip | 96860-4908
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Country | US
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Telephone | 808-471-0255
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Fax |
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Provider Business Mailing Address
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Address Line | 219 ALEXANDER AVE
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City | LOS GATOS
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State | CA
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Zip | 95030-5202
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 3246
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | LD60845361
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License Number State | WA
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