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General NPI Number Information
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NPI Number | 1285149039
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Entity Type | Individual
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Provider Name | ANNA MARIE JILLA AUD, PHD
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Gender | Female
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Dates
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Enumeration Date | 12/01/2017
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 4942 ROLFE CHRISTOPHER DRIVE
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City | BEAUMONT
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State | TX
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Zip | 77705
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Country | US
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Telephone | 409-880-8171
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Fax | 409-880-2265
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Provider Business Mailing Address
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Address Line | PO BOX 10076
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City | BEAUMONT
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State | TX
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Zip | 77710-0076
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Country | US
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Telephone | 409-880-8171
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Fax | 409-880-2265
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 4726
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1186A
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 9751
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 81314
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License Number State | TX
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