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General NPI Number Information
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NPI Number | 1225386493
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Entity Type | Organization
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Legal Business Name | AKAMAI RECOVERY MAUI
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Dates
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Enumeration Date | 08/20/2012
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 2070 W VINEYARD ST SUITE 5
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City | WAILUKU
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State | HI
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Zip | 96793-1699
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Country | US
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Telephone | 808-283-4540
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2908
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City | WAILUKU
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State | HI
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Zip | 96793-7908
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Country | US
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Telephone | 808-283-4540
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DEBRA A BAYER
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Credential | LMFT
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Telephone | 808-283-4540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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