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General NPI Number Information
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NPI Number | 1346065836
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Entity Type | Individual
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Provider Name | JACQUELINE MICHELLE GUERRERO
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Gender | Female
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 609 PARK GROVE DR STE A
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City | KATY
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State | TX
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Zip | 77450-6191
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Country | US
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Telephone | 832-621-1812
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Fax |
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Provider Business Mailing Address
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Address Line | 27006 RIVER BIRCH RIDGE DR
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City | KATY
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State | TX
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Zip | 77493-8156
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Country | US
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Telephone | 281-846-8736
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-22-231065
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License Number State | TX
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