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NPI 1417769068

NPI 1417769068 : AMOR'LYFE JONAE ONWUDI : NORMAL, AL

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General NPI Number Information
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    NPI Number           |    1417769068
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    Entity Type          |    Individual 
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    Provider Name        |    AMOR'LYFE JONAE ONWUDI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/21/2025
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    Last Update Date     |    01/21/2025
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Provider Practice Location Address
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    Address Line         |    4900 MERIDIAN ST NW # 217 
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    City                 |    NORMAL
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    State                |    AL
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    Zip                  |    35762-7500
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    Country              |    US
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    Telephone            |    209-986-1152
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4900 MERIDIAN ST NW # 217 
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    City                 |    NORMAL
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    State                |    AL
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    Zip                  |    35762-7500
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    Country              |    US
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    Telephone            |    209-986-1152
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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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