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General NPI Number Information
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NPI Number | 1770171530
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Entity Type | Organization
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Legal Business Name | KATELYN LIEB ND LLC
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 08/06/2022
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Provider Practice Location Address
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Address Line | 47 OAK ST STE 290
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City | STAMFORD
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State | CT
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Zip | 06905-5320
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Country | US
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Telephone | 203-703-9033
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Fax | 475-268-1002
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Provider Business Mailing Address
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Address Line | 229 BRANFORD RD UNIT 412
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City | NORTH BRANFORD
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State | CT
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Zip | 06471-1316
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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 | OWNER
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Name | DR. KATELYN J LIEB
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Credential | ND
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Telephone | 845-238-1335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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