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NPI 1639919293

NPI 1639919293 : HALEY BUZZETTI : COLUMBIA, SC

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General NPI Number Information
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    NPI Number           |    1639919293
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    Entity Type          |    Individual 
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    Provider Name        |    HALEY BUZZETTI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/30/2024
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    Last Update Date     |    05/30/2024
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Provider Practice Location Address
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    Address Line         |    1154 SUNNYSIDE DR 
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    City                 |    COLUMBIA
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    State                |    SC
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    Zip                  |    29204-3387
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    Country              |    US
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    Telephone            |    803-445-3190
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2079 ELMRIDGE RD 
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    City                 |    COLUMBIA
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    State                |    SC
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    Zip                  |    29209-4363
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    Country              |    US
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    Telephone            |    803-553-0374
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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       |    8720
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    License Number State |    SC
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