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General NPI Number Information
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NPI Number | 1457805228
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Entity Type | Individual
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Provider Name | KATHRYN MOULTON
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Gender | Female
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 28093 SMYTH DR
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City | VALENCIA
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State | CA
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Zip | 91355-4023
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Country | US
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Telephone | 661-295-0181
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Fax | 661-295-9776
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Provider Business Mailing Address
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Address Line | 5567 RESEDA BLVD
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City | TARZANA
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State | CA
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Zip | 91356-2674
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 31387
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License Number State | CA
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