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General NPI Number Information
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NPI Number | 1538040654
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Entity Type | Individual
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Provider Name | RONA S GOLDBERG
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Gender | Female
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 15600 W 10 MILE RD UNIT 13
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2176
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Country | US
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Telephone | 248-289-8009
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Fax |
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Provider Business Mailing Address
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Address Line | 25600 WOODWARD AVE STE 111
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City | ROYAL OAK
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State | MI
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Zip | 48067-0944
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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 |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 7401002761
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License Number State | MI
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