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NPI 1639697121

NPI 1639697121 : SHANNA ROTHSCHILD MFT : AIRMONT, NY

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General NPI Number Information
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    NPI Number           |    1639697121
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    Entity Type          |    Individual 
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    Provider Name        |    SHANNA ROTHSCHILD MFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/05/2017
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    Last Update Date     |    09/05/2017
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Provider Practice Location Address
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    Address Line         |    33 PARK AVE 
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    City                 |    AIRMONT
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    State                |    NY
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    Zip                  |    10952-4505
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    Country              |    US
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    Telephone            |    845-425-9614
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    Fax                  |    845-352-0741
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Provider Business Mailing Address
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    Address Line         |    9 ANN BLVD 
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    City                 |    SPRING VALLEY
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    State                |    NY
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    Zip                  |    10977-6316
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    Country              |    US
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    Telephone            |    845-422-6948
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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        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    
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    License Number State |    
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