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General NPI Number Information
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NPI Number | 1437674520
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Entity Type | Individual
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Provider Name | BRIAN RAY CLAWSON
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Gender | Male
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Dates
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Enumeration Date | 08/09/2017
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Last Update Date | 08/09/2017
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Provider Practice Location Address
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Address Line | 131 W MIDWAY DR
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City | ANAHEIM
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State | CA
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Zip | 92805-6507
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Country | US
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Telephone | 714-517-7107
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Fax |
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Provider Business Mailing Address
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Address Line | 445 FAIR DR APT 203
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City | COSTA MESA
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State | CA
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Zip | 92626-6267
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Country | US
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Telephone | 510-828-6833
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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