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NPI 1629977012

NPI 1629977012 : JEANNE MARIE CHAGNON LMT : EDGEWOOD, MD

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General NPI Number Information
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    NPI Number           |    1629977012
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    Entity Type          |    Individual 
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    Provider Name        |    JEANNE MARIE CHAGNON LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/03/2026
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    Last Update Date     |    11/03/2026
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Provider Practice Location Address
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    Address Line         |    2113 COLUMBIA PARK DR STE 3A 
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    City                 |    EDGEWOOD
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    State                |    MD
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    Zip                  |    21040-1064
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    Country              |    US
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    Telephone            |    443-617-7579
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4302 FOXGLOVE CT 
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    City                 |    BELCAMP
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    State                |    MD
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    Zip                  |    21017-1658
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    Country              |    US
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    Telephone            |    443-617-7579
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    M05097
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    License Number State |    MD
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