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NPI 1659607117

NPI 1659607117 : ROBIN ELFRIEDE POLICKA M.A., L.P.C. : MUSKEGON, MI

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General NPI Number Information
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    NPI Number           |    1659607117
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    Entity Type          |    Individual 
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    Provider Name        |    ROBIN ELFRIEDE POLICKA M.A., L.P.C.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/19/2009
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    Last Update Date     |    09/09/2010
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Provider Practice Location Address
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    Address Line         |    1770 SIMONELLI RD 
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    City                 |    MUSKEGON
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    State                |    MI
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    Zip                  |    49445-8605
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    Country              |    US
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    Telephone            |    231-638-3055
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1206 WHITEHALL RD 
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    City                 |    MUSKEGON
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    State                |    MI
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    Zip                  |    49445-2476
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    Country              |    US
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    Telephone            |    231-638-3055
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    6401010855
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    License Number State |    MI
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