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NPI 1336487776

NPI 1336487776 : PATIENCE MEIGS BOUSEL LMT, CSE, CTP : AMHERST, MA

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General NPI Number Information
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    NPI Number           |    1336487776
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    Entity Type          |    Individual 
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    Provider Name        |    PATIENCE MEIGS BOUSEL LMT, CSE, CTP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/18/2013
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    Last Update Date     |    01/18/2013
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Provider Practice Location Address
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    Address Line         |    800 MAIN ST 
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    City                 |    AMHERST
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    State                |    MA
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    Zip                  |    01002-2854
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    Country              |    US
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    Telephone            |    413-218-7815
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    187 HEATHERSTONE RD 
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    City                 |    AMHERST
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    State                |    MA
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    Zip                  |    01002-1638
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    Country              |    US
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    Telephone            |    413-218-7815
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    Fax                  |    413-253-3846
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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        |    261QP3300X
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    Taxonomy Name        |    Pain Clinic/Center
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    License Number       |    2953
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    License Number State |    MA
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