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NPI 1598297970

NPI 1598297970 : ALLISON RUDNICK MA, LMFT : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1598297970
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    Entity Type          |    Individual 
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    Provider Name        |    ALLISON RUDNICK MA, LMFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/03/2017
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    Last Update Date     |    04/03/2017
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Provider Practice Location Address
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    Address Line         |    8170 BEVERLY BLVD SUITE 203
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90048-4524
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    Country              |    US
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    Telephone            |    323-456-3045
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    308 N SYCAMORE AVE APT 106 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90036-2661
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    Country              |    US
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    Telephone            |    323-456-3056
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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       |    97101
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    License Number State |    CA
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