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General NPI Number Information
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NPI Number | 1669202149
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Entity Type | Individual
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Provider Name | ELIZABETH M. KIACZ MA, AMFT, APCC
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Gender |
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Dates
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Enumeration Date | 08/07/2024
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 444 E HUNTINGTON DR
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City | ARCADIA
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State | CA
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Zip | 91006-6203
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Country | US
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Telephone | 513-763-0179
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Fax |
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Provider Business Mailing Address
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Address Line | 1825 N VERMONT AVE UNIT 27131
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City | LOS ANGELES
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State | CA
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Zip | 90027-6426
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Country | US
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Telephone | 513-763-0179
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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 | 146594
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License Number State | CA
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