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NPI 1770835274

NPI 1770835274 : MELISSA S SHAPIRO CCC-SLP : PHILADELPHIA, PA

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General NPI Number Information
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    NPI Number           |    1770835274
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA S SHAPIRO CCC-SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/08/2012
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    Last Update Date     |    10/08/2012
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Provider Practice Location Address
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    Address Line         |    2001 HAMILTON STREET APT 721
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19130
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    Country              |    US
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    Telephone            |    215-370-2713
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2001 HAMILTON ST APT 721
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19130-4201
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    Country              |    US
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    Telephone            |    215-370-2713
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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        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    41YS00701400
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    License Number State |    NJ
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