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General NPI Number Information
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NPI Number | 1326704933
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Entity Type | Individual
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Provider Name | KYLIN MARISA FLEISCHMANN ATP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 16746 FITZHUGH RD STE 103
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-5462
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Country | US
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Telephone | 512-846-3155
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Fax |
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Provider Business Mailing Address
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Address Line | 764 SAN LUIS
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City | NEW BRAUNFELS
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State | TX
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Zip | 78132-2895
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Country | US
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Telephone | 303-217-3578
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number | 91807
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License Number State | TX
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