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NPI 1265776736

NPI 1265776736 : ANTHONY THONPSON DONISI PCC-S, MA, MS : LAURA, OH

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General NPI Number Information
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    NPI Number           |    1265776736
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    Entity Type          |    Individual 
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    Provider Name        |    ANTHONY THONPSON DONISI PCC-S, MA, MS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/21/2012
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    Last Update Date     |    11/21/2012
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Provider Practice Location Address
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    Address Line         |    3610 DITMER RD 
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    City                 |    LAURA
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    State                |    OH
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    Zip                  |    45337-8742
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    Country              |    US
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    Telephone            |    513-267-9340
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3610 DITMER RD 
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    City                 |    LAURA
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    State                |    OH
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    Zip                  |    45337-8742
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    Country              |    US
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    Telephone            |    513-267-9340
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    E617 SUPV
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    License Number State |    OH
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