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NPI 1619654712

NPI 1619654712 : EPIC INTERVENTIONS LLC : HILO, HI

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General NPI Number Information
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    NPI Number           |    1619654712
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    Entity Type          |    Organization 
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    Legal Business Name  |    EPIC INTERVENTIONS LLC 
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Dates
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    Enumeration Date     |    06/29/2023
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    Last Update Date     |    07/06/2023
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Provider Practice Location Address
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    Address Line         |    136 OHUOHU ST 
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    City                 |    HILO
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    State                |    HI
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    Zip                  |    96720-5264
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    Country              |    US
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    Telephone            |    808-936-1710
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 361 
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    City                 |    KURTISTOWN
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    State                |    HI
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    Zip                  |    96760-0361
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     HEATHER  BLODGETT 
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    Credential           |    LCSW
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    Telephone            |    808-936-1710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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