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General NPI Number Information
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NPI Number | 1215467113
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Entity Type | Individual
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Provider Name | OLIVIA PAULE HAMRAH MD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 2115 WISCONSIN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20007-2265
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Country | US
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Telephone | 202-944-5376
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Fax |
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Provider Business Mailing Address
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Address Line | 7041 ALICENT PL
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City | MC LEAN
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State | VA
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Zip | 22101-4314
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Country | US
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Telephone | 571-221-8841
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD048299
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | MT213135
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License Number State | PA
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