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General NPI Number Information
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NPI Number | 1659099695
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Entity Type | Individual
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Provider Name | MONIQUE STEVENSON
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Gender | Female
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 111 N. MLK JR ST
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City | TRINITY
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State | TX
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Zip | 75862
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Country | US
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Telephone | 936-800-8555
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2886
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City | TRINITY
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State | TX
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Zip | 75862-2886
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Country | US
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Telephone | 936-800-8555
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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