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General NPI Number Information
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NPI Number | 1700515780
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Entity Type | Individual
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Provider Name | PHOEBE MARY MISSIOS
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Gender | Female
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Dates
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Enumeration Date | 06/06/2022
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 337 W MISSION AVE
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City | ESCONDIDO
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State | CA
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Zip | 92025-1729
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Country | US
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Telephone | 760-745-0281
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Fax | 760-745-0778
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Provider Business Mailing Address
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Address Line | 3611 CHAIN BRIDGE RD STE C&D
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City | FAIRFAX
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State | VA
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Zip | 22030-3246
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Country | US
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Telephone | 703-380-9045
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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