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NPI 1356430219

NPI 1356430219 : TERESA H MULLINAX L.P.C. : ANNISTON, AL

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General NPI Number Information
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    NPI Number           |    1356430219
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    Entity Type          |    Individual 
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    Provider Name        |    TERESA H MULLINAX L.P.C.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/11/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    115 E 21ST ST 
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    City                 |    ANNISTON
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    State                |    AL
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    Zip                  |    36201-3209
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    Country              |    US
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    Telephone            |    256-237-1547
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    Fax                  |    256-237-1548
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1473 
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    City                 |    ANNISTON
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    State                |    AL
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    Zip                  |    36202-1473
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    Country              |    US
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    Telephone            |    256-237-1547
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    Fax                  |    256-237-1548
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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        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    1786
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    License Number State |    AL
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