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General NPI Number Information
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NPI Number | 1508975137
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Entity Type | Individual
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Provider Name | AMANDA HAMMON GUILLOTTE AU.D.
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 3017 13TH ST
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City | GULFPORT
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State | MS
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Zip | 39501-1833
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Country | US
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Telephone | 228-863-6592
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 PINE CONE DR
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City | GAUTIER
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State | MS
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Zip | 39553-2353
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Country | US
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Telephone | 228-218-1373
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A2920
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License Number State | MS
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