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General NPI Number Information
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NPI Number | 1275809790
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Entity Type | Individual
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Provider Name | DANIEL JAMES MITCHELL OTR
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Gender | Male
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/07/2015
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Provider Practice Location Address
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Address Line | 99 MULFORD RD
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City | ANDOVER
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State | NJ
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Zip | 07821-2600
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Country | US
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Telephone | 973-383-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 164 WEST SHORE TRAIL
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City | SPARTA
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State | NJ
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Zip | 07871-1624
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Country | US
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Telephone | 973-729-8989
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR00174800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC-004588-L
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License Number State | PA
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