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NPI 1598480204

NPI 1598480204 : CHERI DENT LCPC : NAMPA, ID

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General NPI Number Information
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    NPI Number           |    1598480204
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    Entity Type          |    Individual 
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    Provider Name        |    CHERI DENT LCPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/05/2022
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    Last Update Date     |    02/19/2025
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Provider Practice Location Address
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    Address Line         |    104 9TH AVE S STE A5 
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    City                 |    NAMPA
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    State                |    ID
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    Zip                  |    83651-3805
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    Country              |    US
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    Telephone            |    208-614-1057
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    312 S BUTTERCUP CT 
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    City                 |    NAMPA
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    State                |    ID
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    Zip                  |    83687-8991
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    Country              |    US
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    Telephone            |    208-250-4529
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    8331410
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    License Number State |    ID
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Taxonomy #2
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    8331410
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    License Number State |    ID
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