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General NPI Number Information
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NPI Number | 1467937094
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Entity Type | Organization
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Legal Business Name | CLARITY THERAPY CENTER LLC
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Dates
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Enumeration Date | 09/29/2018
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Last Update Date | 09/29/2018
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Provider Practice Location Address
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Address Line | 200 MASON ST STE 11
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City | ONALASKA
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State | WI
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Zip | 54650-7061
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Country | US
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Telephone | 608-765-5501
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MASON ST STE 11
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City | ONALASKA
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State | WI
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Zip | 54650-7061
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Country | US
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Telephone | 608-765-5501
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN ANN MCDONALD-CONROY
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Credential | MS
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Telephone | 608-769-1002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family 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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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