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General NPI Number Information
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NPI Number | 1467997130
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Entity Type | Organization
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Legal Business Name | THRIVE THERAPY SERVICES LLC
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Dates
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Enumeration Date | 01/04/2017
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 843 CUTSPRING RD
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City | STRATFORD
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State | CT
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Zip | 06614-2448
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Country | US
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Telephone | 203-727-8438
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 400
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City | NORTH STONINGTON
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State | CT
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Zip | 06359-0400
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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 | SPEECH LANGUAGE PATHOLOGIST
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Name | ROBYN NICHOLAS
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Credential | SLP
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Telephone | 203-727-8438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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