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NPI 1619017209

NPI 1619017209 : SUSAN BOYD MS., MFT : BAKERSFIELD, CA

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General NPI Number Information
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    NPI Number           |    1619017209
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    Entity Type          |    Individual 
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    Provider Name        |    SUSAN BOYD MS., MFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/06/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    9711 HOLLAND ST 
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    City                 |    BAKERSFIELD
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    State                |    CA
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    Zip                  |    93312-2772
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    Country              |    US
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    Telephone            |    661-322-1020
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    Fax                  |    661-322-0552
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Provider Business Mailing Address
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    Address Line         |    2521 SUTTON PL 
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    City                 |    BAKERSFIELD
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    State                |    CA
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    Zip                  |    93309-4402
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    Country              |    US
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    Telephone            |    661-397-8323
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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       |    MFC32534
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    License Number State |    CA
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