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General NPI Number Information
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NPI Number | 1275338873
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Entity Type | Organization
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Legal Business Name | NOMAD SPEECH THERAPY SERVICES LLC
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 404 W DUTCH AVE
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City | SALLISAW
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State | OK
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Zip | 74955-2614
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Country | US
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Telephone | 918-208-3279
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Fax |
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Provider Business Mailing Address
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Address Line | 6205 ATLANTA ST
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City | FORT SMITH
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State | AR
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Zip | 72903-4921
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Country | US
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Telephone | 918-208-3279
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | SAMANTHA DEE MCDONALD
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Credential | MS,CCC-SLP
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Telephone | 918-208-3279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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