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General NPI Number Information
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NPI Number | 1336810548
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Entity Type | Organization
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Legal Business Name | RELIABLE MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 1103 WARM WINDS DR
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City | O FALLON
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State | MO
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Zip | 63366-6327
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Country | US
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Telephone | 636-306-1330
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Fax | 636-306-1330
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Provider Business Mailing Address
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Address Line | 2977 HIGHWAY K STE 141
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City | O FALLON
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State | MO
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Zip | 63368-7862
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Country | US
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Telephone | 636-306-1330
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Fax | 636-410-9217
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MRS. FARAH LYNN SHADDIX
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Credential | PMHNP-BC
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Telephone | 636-306-1330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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