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General NPI Number Information
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NPI Number | 1659652246
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Entity Type | Organization
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Legal Business Name | SYNERGIC THERAPY, INC
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Dates
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Enumeration Date | 09/08/2011
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Last Update Date | 09/08/2011
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Provider Practice Location Address
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Address Line | 1150 S BASCOM AVE SUITE 17
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City | SAN JOSE
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State | CA
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Zip | 95128-3509
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Country | US
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Telephone | 408-375-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 S BASCOM AVE SUITE 17
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City | SAN JOSE
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State | CA
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Zip | 95128-3509
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Country | US
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Telephone | 408-375-4333
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Fax |
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Authorized Official
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Title or Position | CEO/SYNERGIC THERAPY, INC
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Name | MS. ANJLEE PATEL
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Credential | M.A., CCC-SLP, M.ED.
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Telephone | 408-375-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | SP 17336
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License Number State | CA
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