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General NPI Number Information
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NPI Number | 1639472392
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Entity Type | Individual
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Provider Name | KATHERINE MCDONALD LMHC
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Gender | Female
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 140 E PARK AVE
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City | LAKE WALES
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State | FL
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Zip | 33853-4124
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Country | US
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Telephone | 863-535-5246
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Fax |
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Provider Business Mailing Address
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Address Line | 967 SALLY RD
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City | LAKE WALES
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State | FL
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Zip | 33853-2730
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Country | US
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Telephone | 863-605-2232
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A1101010
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P1203035
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License Number State | AR
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