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General NPI Number Information
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NPI Number | 1265553952
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Entity Type | Individual
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Provider Name | LAVERNE BEAL MILLER M.ED
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 425 N 1ST ST
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City | IMMOKALEE
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State | FL
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Zip | 34142-3150
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Country | US
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Telephone | 239-657-4434
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Fax | 239-657-4331
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Provider Business Mailing Address
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Address Line | 4951 22ND ST NE
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City | NAPLES
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State | FL
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Zip | 34120-0405
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Country | US
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Telephone | 239-657-4434
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Fax | 239-657-4331
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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