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General NPI Number Information
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NPI Number | 1649087198
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Entity Type | Individual
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Provider Name | DANI JADE BORER
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Gender |
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 75-5995 KUAKINI HWY STE 221
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City | KAILUA KONA
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State | HI
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Zip | 96740-2120
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Country | US
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Telephone | 808-465-3005
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Fax |
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Provider Business Mailing Address
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Address Line | 2660 JULIAN ST
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City | DENVER
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State | CO
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Zip | 80211-4023
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Country | US
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Telephone | 858-243-3007
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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 | LPCC.0022835
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License Number State | CO
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