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General NPI Number Information
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NPI Number | 1417438417
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Entity Type | Organization
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Legal Business Name | KAHL THERAPY CORNER, LLC
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 11/22/2021
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Provider Practice Location Address
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Address Line | 1500 N 16TH ST
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-0150
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Country | US
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Telephone | 712-310-8395
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Fax | 888-975-0225
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Provider Business Mailing Address
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Address Line | 1415 W BROADWAY
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-3922
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Country | US
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Telephone | 712-308-8233
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Fax | 888-975-0225
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Authorized Official
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Title or Position | OWNER/SPEECH LANGAUGE PATHOLOGIST
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Name | JILLIAN KAHL
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Credential | MA CCC-SLP
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Telephone | 712-310-8395
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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 |
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License Number State | IA
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