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General NPI Number Information
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NPI Number | 1619141470
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Entity Type | Organization
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Legal Business Name | CLINICAL PSYCHOLOGICAL SERVICES, INC.
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 1927 BUFORD BLVD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4466
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Country | US
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Telephone | 850-309-0811
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Fax | 850-309-0812
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Provider Business Mailing Address
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Address Line | 1927 BUFORD BLVD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4466
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Country | US
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Telephone | 850-309-0811
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Fax | 850-309-0812
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | MR. JAMES G BROWN
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Credential | PH.D.
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Telephone | 850-309-0811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY3424
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License Number State | FL
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