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NPI 1639672934

NPI 1639672934 : ELIZABETH JEANNE GRIFFITH GARDNER : TAUNTON, MA

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General NPI Number Information
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    NPI Number           |    1639672934
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    Entity Type          |    Individual 
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    Provider Name        |    ELIZABETH JEANNE GRIFFITH GARDNER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/13/2018
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    Last Update Date     |    03/13/2018
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Provider Practice Location Address
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    Address Line         |    26U HOPKINS RD 
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    City                 |    TAUNTON
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    State                |    MA
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    Zip                  |    02780-3724
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    Country              |    US
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    Telephone            |    203-868-9401
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    26U HOPKINS RD 
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    City                 |    TAUNTON
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    State                |    MA
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    Zip                  |    02780-3724
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    Country              |    US
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    Telephone            |    203-868-9401
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    222770
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    License Number State |    MA
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