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General NPI Number Information
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NPI Number | 1649357906
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Entity Type | Individual
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Provider Name | KEVIN WARREN PSYD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 8911 E ORME ST SUITE A
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City | WICHITA
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State | KS
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Zip | 67207-2423
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Country | US
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Telephone | 316-686-7884
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Fax | 316-686-0036
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Provider Business Mailing Address
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Address Line | 1 KALISA WAY STE 101
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City | PARAMUS
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State | NJ
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Zip | 07652-3508
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Country | US
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Telephone | 888-948-6789
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Fax | 877-345-3501
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1068
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License Number State | KS
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