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General NPI Number Information
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NPI Number | 1487944880
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Entity Type | Individual
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Provider Name | JULIE L WILLIAMSON
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Gender | Female
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 09/14/2015
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Provider Practice Location Address
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Address Line | 10880 BAUR BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63132-1632
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Country | US
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Telephone | 314-608-0092
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 BIG BEND CROSSING DR
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City | MANCHESTER
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State | MO
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Zip | 63088-1276
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Country | US
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Telephone | 314-608-0092
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2010041600
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License Number State | MO
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