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General NPI Number Information
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NPI Number | 1265252803
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Entity Type | Individual
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Provider Name | ANDREA NICOLE POND
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Gender | Female
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 2655 VILLA CREEK DR
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City | FARMERS BRANCH
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State | TX
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Zip | 75234-7324
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Country | US
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Telephone | 214-736-8376
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Fax |
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Provider Business Mailing Address
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Address Line | 2655 VILLA CREEK DR
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City | FARMERS BRANCH
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State | TX
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Zip | 75234-7324
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Country | US
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Telephone | 214-736-3768
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-24-376132
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License Number State | TX
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