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General NPI Number Information
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NPI Number | 1386449114
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Entity Type | Individual
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Provider Name | AUTUMN ROSE CIPRIANO
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Gender | Female
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 304 MAIN ST # A
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City | FARMINGTON
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State | CT
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Zip | 06032-2985
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Country | US
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Telephone | 860-674-1824
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Fax |
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Provider Business Mailing Address
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Address Line | 1198 WOODTICK RD
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City | WOLCOTT
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State | CT
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Zip | 06716-2125
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Country | US
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Telephone | 203-805-9544
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 18.007997
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License Number State | CT
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