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NPI 1316141393

NPI 1316141393 : STEPHANIE R DONATO M.A, LPC UNDER SUPER : MCALESTER, OK

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General NPI Number Information
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    NPI Number           |    1316141393
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    Entity Type          |    Individual 
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    Provider Name        |    STEPHANIE R DONATO M.A, LPC UNDER SUPER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/13/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    503 S 2ND ST 
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    City                 |    MCALESTER
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    State                |    OK
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    Zip                  |    74501-5811
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    Country              |    US
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    Telephone            |    918-423-1953
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1807 WOOD RD 
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    City                 |    MCALESTER
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    State                |    OK
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    Zip                  |    74501-7264
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    Country              |    US
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    Telephone            |    
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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        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    
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