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General NPI Number Information
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NPI Number | 1598154346
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Entity Type | Organization
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Legal Business Name | E-THERAPY
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Dates
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Enumeration Date | 01/16/2015
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 2812 W HARE DR
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-2583
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Country | US
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Telephone | 928-814-4990
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 93
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City | HARRISON
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State | NY
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Zip | 10528-0093
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Country | US
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Telephone | 928-814-4990
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MS. DIANA PARAFINIUK
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Credential |
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Telephone | 928-814-4990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 101475
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License Number State | AZ
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