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NPI 1376691188

NPI 1376691188 : MS. LESLIE ANN QUINN : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1376691188
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    Entity Type          |    Individual 
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    Provider Name        |    MS. LESLIE ANN QUINN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/08/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2001 S BARRINGTON AVE 202
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90025-5363
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    Country              |    US
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    Telephone            |    310-288-7147
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2001 S BARRINGTON AVE 202
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90025-5363
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    Country              |    US
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    Telephone            |    310-288-7147
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    MFC27438
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    License Number State |    CA
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