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NPI 1699137885

NPI 1699137885 : LOUISE ROSE CALHOUN OTR/L : VALLEJO, CA

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General NPI Number Information
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    NPI Number           |    1699137885
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    Entity Type          |    Individual 
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    Provider Name        |    LOUISE ROSE CALHOUN OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/25/2016
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    Last Update Date     |    01/15/2022
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Provider Practice Location Address
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    Address Line         |    207 WOODSON WAY 
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    City                 |    VALLEJO
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    State                |    CA
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    Zip                  |    94591-4153
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    Country              |    US
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    Telephone            |    707-373-6022
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    207 WOODSON WAY 
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    City                 |    VALLEJO
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    State                |    CA
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    Zip                  |    94591-4153
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    Country              |    US
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    Telephone            |    707-373-6022
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    13745
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    License Number State |    CA
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