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NPI 1588260509

NPI 1588260509 : MEGAN BURFORD AMFT : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1588260509
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    Entity Type          |    Individual 
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    Provider Name        |    MEGAN BURFORD AMFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/06/2020
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    Last Update Date     |    12/06/2020
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Provider Practice Location Address
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    Address Line         |    12304 SANTA MONICA BLVD STE 379 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90025-1542
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    Country              |    US
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    Telephone            |    213-375-8128
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3705 W PICO BLVD PO BOX 2599
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90019
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    Country              |    US
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    Telephone            |    213-375-8128
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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        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    119529
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    119529
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    License Number State |    CA
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