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NPI 1699900415

NPI 1699900415 : LAUREN SPEER : SAPULPA, OK

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General NPI Number Information
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    NPI Number           |    1699900415
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    Entity Type          |    Individual 
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    Provider Name        |    LAUREN SPEER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/22/2009
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    Last Update Date     |    01/06/2014
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Provider Practice Location Address
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    Address Line         |    32 N WATER ST 
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    City                 |    SAPULPA
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    State                |    OK
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    Zip                  |    74066-2816
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    Country              |    US
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    Telephone            |    918-224-9185
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    32 N WATER ST 
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    City                 |    SAPULPA
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    State                |    OK
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    Zip                  |    74066-2816
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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        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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