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General NPI Number Information
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NPI Number | 1255271441
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Entity Type | Individual
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Provider Name | DESTYNEE ANNE MARIE MITTELSTEDT
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Gender | Female
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Dates
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Enumeration Date | 03/30/2026
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 3326 ASPEN GROVE DR UNIT 604
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City | FRANKLIN
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State | TN
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Zip | 37067-2837
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Country | US
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Telephone | 629-236-4547
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Fax |
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Provider Business Mailing Address
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Address Line | 300 INTERNATIONAL PKWY STE 200
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City | LAKE MARY
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State | FL
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Zip | 32746-5028
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Country | US
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Telephone | 866-610-0580
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Fax | 866-611-1558
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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