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General NPI Number Information
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NPI Number | 1245615111
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Entity Type | Individual
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Provider Name | SAMANTHA LEE DOOLITTLE M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/21/2015
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Last Update Date | 01/31/2019
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Provider Practice Location Address
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Address Line | MOSAIC REHABILITATION 6325 JACKRABBIT LN #A
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City | BELGRADE
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State | MT
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Zip | 59714
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Country | US
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Telephone | 406-388-4988
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6456
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City | BOZEMAN
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State | MT
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Zip | 59771-6456
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Country | US
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Telephone | 605-641-4231
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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 | 14065609ASHA
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License Number State |
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