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General NPI Number Information
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NPI Number | 1487700456
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Entity Type | Individual
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Provider Name | TERESA ANN LANCASTER M.S., SLP-CCC
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 01/14/2009
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Provider Practice Location Address
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Address Line | 311 N 10TH ST
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4280
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Country | US
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Telephone | 208-664-2659
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Fax |
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Provider Business Mailing Address
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Address Line | 493 E IOWA AVE
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City | HAYDEN
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State | ID
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Zip | 83835-9275
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Country | US
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Telephone | 208-304-0236
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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 | 1632
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License Number State | ID
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