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NPI 1427451186

NPI 1427451186 : MELODY WILDING LMSW : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1427451186
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    Entity Type          |    Individual 
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    Provider Name        |    MELODY WILDING LMSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/08/2014
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    Last Update Date     |    10/08/2014
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Provider Practice Location Address
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    Address Line         |    333 E 86TH ST 3A
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10028-4711
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    Country              |    US
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    Telephone            |    862-221-0404
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3 HONEYSUCKLE LN 
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    City                 |    KINNELON
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    State                |    NJ
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    Zip                  |    07405-3001
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    Country              |    US
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    Telephone            |    
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    084441
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    License Number State |    NY
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