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NPI 1750649349

NPI 1750649349 : RAQUEL SWEAT OTR/L : NORTH LAS VEGAS, NV

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General NPI Number Information
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    NPI Number           |    1750649349
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    Entity Type          |    Individual 
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    Provider Name        |    RAQUEL SWEAT OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/02/2012
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    Last Update Date     |    03/09/2022
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Provider Practice Location Address
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    Address Line         |    6935 ALIANTE PKWY # 104-190 
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    City                 |    NORTH LAS VEGAS
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    State                |    NV
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    Zip                  |    89084-5818
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    Country              |    US
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    Telephone            |    702-398-7031
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6935 ALIANTE PKWY # 104-190 
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    City                 |    NORTH LAS VEGAS
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    State                |    NV
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    Zip                  |    89084-5818
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    11-0187
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    License Number State |    NV
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