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NPI 1255142956

NPI 1255142956 : MAYA WHITE : ARLINGTON, VA

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General NPI Number Information
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    NPI Number           |    1255142956
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    Entity Type          |    Individual 
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    Provider Name        |    MAYA WHITE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/14/2025
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    Last Update Date     |    01/14/2025
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Provider Practice Location Address
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    Address Line         |    4040 FAIRFAX DR STE 200 
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    City                 |    ARLINGTON
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    State                |    VA
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    Zip                  |    22203-1613
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    Country              |    US
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    Telephone            |    703-284-5980
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1008 N GLEBE RD APT 409 
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    City                 |    ARLINGTON
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    State                |    VA
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    Zip                  |    22201-5647
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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