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General NPI Number Information
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NPI Number | 1528643111
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Entity Type | Organization
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Legal Business Name | SPECTRUMCARE, LLC.
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 1008 FAIRLANE DR
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City | VANCEBURG
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State | KY
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Zip | 41179-5403
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Country | US
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Telephone | 740-981-3176
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Fax | 740-259-2363
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Provider Business Mailing Address
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Address Line | 1112 GALLIA ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4161
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LEAH ANN JOYCE
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Credential | BCBA
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Telephone | 740-370-4486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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