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General NPI Number Information
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NPI Number | 1275287286
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Entity Type | Individual
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Provider Name | DONALD DAVID ST. LOUIS D. MIN., MFT
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Gender | Male
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 2797 PARK AVE STE 203
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City | SANTA CLARA
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State | CA
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Zip | 95050
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Country | US
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Telephone | 415-776-4110
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Fax |
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Provider Business Mailing Address
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Address Line | 2797 PARK AVE. STE 203
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City | SANTA CLARA
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State | CA
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Zip | 95050
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Country | US
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Telephone | 415-764-4110
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC31106
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License Number State | CA
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