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NPI 1245864776

NPI 1245864776 : LAURA BARNEY, LLC : FOUNTAIN, CO

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General NPI Number Information
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    NPI Number           |    1245864776
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    Entity Type          |    Organization 
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    Legal Business Name  |    LAURA BARNEY, LLC 
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Dates
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    Enumeration Date     |    02/24/2020
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    Last Update Date     |    02/24/2020
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Provider Practice Location Address
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    Address Line         |    108 W OHIO AVE # B 
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    City                 |    FOUNTAIN
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    State                |    CO
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    Zip                  |    80817-2240
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    Country              |    US
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    Telephone            |    406-350-2515
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    733 ALEXANDER RD APT D 
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    City                 |    COLORADO SPRINGS
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    State                |    CO
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    Zip                  |    80909-4860
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    Country              |    US
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    Telephone            |    406-350-2515
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    Fax                  |    
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Authorized Official
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    Title or Position    |    LPC
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    Name                 |     LAURA  BARNEY 
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    Credential           |    LPC
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    Telephone            |    406-350-2515
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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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