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General NPI Number Information
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NPI Number | 1487415378
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Entity Type | Individual
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Provider Name | JILL RENAE GOODMAN
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Gender | Female
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 9700 E EASTER LN
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City | CENTENNIAL
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State | CO
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Zip | 80112-1136
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Country | US
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Telephone | 720-804-6407
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Fax |
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Provider Business Mailing Address
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Address Line | 6588 W OTTAWA AVE
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City | LITTLETON
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State | CO
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Zip | 80128-4572
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Country | US
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Telephone | 303-933-1393
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC.0019720
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License Number State | CO
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