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NPI 1437360054

NPI 1437360054 : BETH INGRAM & ASSOCIATES, LLC : LAKELAND, FL

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General NPI Number Information
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    NPI Number           |    1437360054
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    Entity Type          |    Organization 
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    Legal Business Name  |    BETH INGRAM & ASSOCIATES, LLC 
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Dates
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    Enumeration Date     |    05/25/2007
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    Last Update Date     |    06/06/2024
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Provider Practice Location Address
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    Address Line         |    1818 HARDEN BLVD SUITE 160
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    City                 |    LAKELAND
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    State                |    FL
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    Zip                  |    33803-1812
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    Country              |    US
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    Telephone            |    813-653-1149
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    Fax                  |    813-654-6644
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Provider Business Mailing Address
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    Address Line         |    1818 HARDEN BLVD STE 160 
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    City                 |    LAKELAND
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    State                |    FL
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    Zip                  |    33803-1824
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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    |    DIRECTOR OF OPERATIONS
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    Name                 |     VANESSA  BANKS 
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    Credential           |    
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    Telephone            |    813-508-2991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    222Q00000X
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    Taxonomy Name        |    Developmental Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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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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