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General NPI Number Information
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NPI Number | 1326654799
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Entity Type | Organization
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Legal Business Name | REPLENISH THERAPY LLC
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 09/21/2020
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Provider Practice Location Address
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Address Line | 1009 E RED BUD RD
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City | KNOXVILLE
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State | TN
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Zip | 37920-8807
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Country | US
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Telephone | 865-269-2570
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Fax | 865-269-2558
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Provider Business Mailing Address
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Address Line | PO BOX 9385
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City | KNOXVILLE
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State | TN
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Zip | 37940-0385
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Country | US
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Telephone | 865-269-2570
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Fax | 868-269-2558
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | BETHANY TOWNSEND
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Credential | L.C.S.W.
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Telephone | 865-269-2570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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