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General NPI Number Information
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NPI Number | 1316601339
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Entity Type | Organization
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Legal Business Name | FAMILY COLLABORATIONS LLC
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 2055 CRAIGSHIRE RD STE 120
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City | SAINT LOUIS
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State | MO
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Zip | 63146-4012
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Country | US
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Telephone | 314-974-7018
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Fax | 314-392-9601
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Provider Business Mailing Address
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Address Line | 15 FORSYTHIA LN
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City | OLIVETTE
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State | MO
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Zip | 63132-2003
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Country | US
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Telephone | 314-974-7018
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Fax | 314-392-9601
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Authorized Official
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Title or Position | OWNER AND CLINICAL THERAPIST
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Name | JANE M. SMITH
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Credential | LPC
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Telephone | 314-974-7018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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