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General NPI Number Information
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NPI Number | 1386405546
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Entity Type | Organization
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Legal Business Name | ANCHOR WAVE THERAPY
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 7831 E BUSH LAKE RD STE 200D
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City | MINNEAPOLIS
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State | MN
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Zip | 55439-3164
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Country | US
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Telephone | 612-662-7407
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Fax | 612-500-4918
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Provider Business Mailing Address
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Address Line | 5800 DALE AVE
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City | EDINA
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State | MN
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Zip | 55436-2473
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Country | US
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Telephone | 561-779-8179
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | DR. CAROLYN BERGER
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Credential | LPCC, LMHC
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Telephone | 561-779-8179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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