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General NPI Number Information
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NPI Number | 1205583283
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Entity Type | Individual
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Provider Name | SARAH REZAK LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 1460 7TH ST STE 300
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City | SANTA MONICA
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State | CA
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Zip | 90401-2632
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Country | US
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Telephone | 323-285-0107
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Fax |
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Provider Business Mailing Address
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Address Line | 2029 OAK ST APT B
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City | SANTA MONICA
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State | CA
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Zip | 90405-4969
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Country | US
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Telephone | 310-804-3240
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 131603
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License Number State | CA
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