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General NPI Number Information
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NPI Number | 1760381883
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Entity Type | Individual
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Provider Name | JOSEPHINE MARIE LIZZO
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Gender | Female
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 7300 MCEWEN RD
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City | DAYTON
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State | OH
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Zip | 45459-3903
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Country | US
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Telephone | 937-433-3441
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Fax | 937-433-6207
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Provider Business Mailing Address
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Address Line | 2491 SPICER DR
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City | BEAVERCREEK
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State | OH
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Zip | 45431-2488
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Country | US
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Telephone | 520-789-2161
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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 | 136A00000X
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Taxonomy Name | Registered Dietetic Technician
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License Number |
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License Number State | OH
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