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General NPI Number Information
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NPI Number | 1306954862
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Entity Type | Individual
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Provider Name | MARCIA ANN MAXWELL-BROWN CCC SLP
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Gender | Female
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Dates
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Enumeration Date | 08/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 121 OPPORTUNITY DRIVE SCHOHARIE ARC
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City | SCHOHARIE
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State | NY
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Zip | 12157
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Country | US
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Telephone | 518-295-8810
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 281 113 CHAPEL ST
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City | COBLESKILL
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State | NY
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Zip | 12043
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Country | US
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Telephone | 518-234-2479
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Fax | 518-234-2479
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 003860-1
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License Number State | NY
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