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General NPI Number Information
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NPI Number | 1689087181
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Entity Type | Individual
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Provider Name | ERIN LEE
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Gender | Female
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 13230 MANCHESTER RD
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City | DES PERES
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State | MO
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Zip | 63131-1706
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Country | US
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Telephone | 314-821-2816
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Fax |
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Provider Business Mailing Address
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Address Line | 1448 WOOD HAVEN DR
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City | SAINT CHARLES
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State | MO
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Zip | 63304-5081
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2010018692
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License Number State | MO
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