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General NPI Number Information
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NPI Number | 1720804222
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Entity Type | Individual
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Provider Name | AMBER ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 11/29/2024
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 34441 8 MILE RD STE 115
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City | LIVONIA
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State | MI
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Zip | 48152-4013
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Country | US
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Telephone | 734-469-0513
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Fax |
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Provider Business Mailing Address
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Address Line | 27330 ARBORWAY RD UNIT 32
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3584
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Country | US
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Telephone | 313-766-1697
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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 | 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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