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NPI 1407391980

NPI 1407391980 : WHITNEY GRIGSBY : LOVELAND, CO

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General NPI Number Information
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    NPI Number           |    1407391980
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    Entity Type          |    Individual 
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    Provider Name        |    WHITNEY GRIGSBY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/20/2016
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    Last Update Date     |    12/20/2016
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Provider Practice Location Address
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    Address Line         |    5323 CEDAR VALLEY DRIVE 
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    City                 |    LOVELAND
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    State                |    CO
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    Zip                  |    80537
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    Country              |    US
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    Telephone            |    720-771-0047
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5323 CEDAR VALLEY DR 
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    City                 |    LOVELAND
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    State                |    CO
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    Zip                  |    80537-7974
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    Country              |    US
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    Telephone            |    720-771-0047
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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       |    
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    License Number State |    
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