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NPI 1710144894

NPI 1710144894 : SARAH C HALL SLP : GRAND RAPIDS, MI

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General NPI Number Information
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    NPI Number           |    1710144894
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    Entity Type          |    Individual 
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    Provider Name        |    SARAH C HALL SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/17/2008
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    Last Update Date     |    05/17/2008
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Provider Practice Location Address
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    Address Line         |    2320 E BELTLINE AVE SE 
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    City                 |    GRAND RAPIDS
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    State                |    MI
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    Zip                  |    49546-5906
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    Country              |    US
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    Telephone            |    616-949-3000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3608 100TH ST SW 
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    City                 |    BYRON CENTER
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    State                |    MI
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    Zip                  |    49315-9033
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    Country              |    US
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    Telephone            |    616-878-9698
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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        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    
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    License Number State |    
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