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General NPI Number Information
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NPI Number | 1487786539
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Entity Type | Organization
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Legal Business Name | AYD & CAVANAGH, LLC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9007 KAGAN AVE NE
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City | MONTICELLO
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State | MN
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Zip | 55362-4535
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Country | US
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Telephone | 612-229-1234
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Fax | 763-295-4946
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Provider Business Mailing Address
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Address Line | 9007 KAGAN AVE NE
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City | MONTICELLO
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State | MN
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Zip | 55362-4535
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Country | US
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Telephone | 612-229-1234
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Fax | 763-295-4946
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MICHELE BATKIEWICZ
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Credential |
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Telephone | 612-710-3671
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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 | LP4403
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License Number State | MN
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