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General NPI Number Information
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NPI Number | 1750600722
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Entity Type | Individual
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Provider Name | KODI ALVINEE' POLLARD MA, MHR, CM II
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Gender | Female
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Dates
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Enumeration Date | 05/28/2010
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 1330 N CLASSEN BLVD STE 105
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City | OKLAHOMA CITY
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State | OK
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Zip | 73106-6834
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Country | US
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Telephone | 405-812-0197
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Fax |
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Provider Business Mailing Address
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Address Line | 700 NE 122ND ST APT 1808
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City | OKLAHOMA CITY
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State | OK
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Zip | 73114-8154
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Country | US
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Telephone | 405-921-0082
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 316428
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License Number State | OK
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