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NPI 1619668241

NPI 1619668241 : KATE BARD ATR-BC, LCAT, SAC : LEICESTER, MA

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General NPI Number Information
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    NPI Number           |    1619668241
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    Entity Type          |    Individual 
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    Provider Name        |    KATE BARD ATR-BC, LCAT, SAC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/16/2023
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    Last Update Date     |    05/16/2023
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Provider Practice Location Address
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    Address Line         |    220 PAXTON ST 
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    City                 |    LEICESTER
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    State                |    MA
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    Zip                  |    01524-1117
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    Country              |    US
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    Telephone            |    718-637-1751
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    220 PAXTON ST 
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    City                 |    LEICESTER
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    State                |    MA
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    Zip                  |    01524-1117
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    Country              |    US
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    Telephone            |    718-637-1751
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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        |    101YS0200X
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    Taxonomy Name        |    School Counselor
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    License Number       |    507636
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    License Number State |    MA
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Taxonomy #2
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    Taxonomy Code        |    221700000X
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    Taxonomy Name        |    Art Therapist
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    License Number       |    001324
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    License Number State |    NY
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