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General NPI Number Information
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NPI Number | 1437202702
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Entity Type | Organization
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Legal Business Name | D & K CARE SERVICE
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 3200 HOLLYWOOD AVE
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City | SHREVEPORT
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State | LA
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Zip | 71108
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Country | US
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Telephone | 318-631-0805
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Fax | 318-631-1192
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Provider Business Mailing Address
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Address Line | 4185 DEER CREEK DRIVE
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City | SHREVEPORT
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State | LA
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Zip | 71119-7513
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Country | US
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Telephone | 318-631-5258
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Fax | 318-631-1192
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LEROY EALY
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Credential |
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Telephone | 318-631-0805
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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 |
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