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NPI 1215410196

NPI 1215410196 : VICTORIA WHITFORD : HORSEHEADS, NY

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General NPI Number Information
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    NPI Number           |    1215410196
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    Entity Type          |    Individual 
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    Provider Name        |    VICTORIA WHITFORD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/07/2018
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    Last Update Date     |    09/07/2018
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Provider Practice Location Address
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    Address Line         |    950 SING SING RD 
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    City                 |    HORSEHEADS
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    State                |    NY
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    Zip                  |    14845-1301
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    Country              |    US
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    Telephone            |    607-730-6357
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    930 FASSETT RD 
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    City                 |    ELMIRA
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    State                |    NY
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    Zip                  |    14905-1434
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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        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    027950-1
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    License Number State |    NY
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