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NPI 1467639583

NPI 1467639583 : ANN BROST MA COUNSELING AGENCY : CHADRON, NE

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General NPI Number Information
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    NPI Number           |    1467639583
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    Entity Type          |    Organization 
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    Legal Business Name  |    ANN BROST MA COUNSELING AGENCY 
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Dates
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    Enumeration Date     |    01/31/2008
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    Last Update Date     |    12/02/2013
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Provider Practice Location Address
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    Address Line         |    301 WEST 2ND ST 
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    City                 |    CHADRON
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    State                |    NE
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    Zip                  |    69337
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    Country              |    US
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    Telephone            |    308-432-6779
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    Fax                  |    308-432-6874
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Provider Business Mailing Address
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    Address Line         |    301 WEST 2ND ST 
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    City                 |    CHADRON
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    State                |    NE
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    Zip                  |    69337
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    Country              |    US
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    Telephone            |    308-432-6779
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    Fax                  |    308-432-6874
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Authorized Official
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    Title or Position    |    OWNER LMHP THERAPIST
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    Name                 |    MRS. REBECCA ANN BROST 
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    Credential           |    LMHP
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    Telephone            |    308-432-6779
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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       |    2653
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    License Number State |    NE
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