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NPI 1790198729

NPI 1790198729 : DEB SMITH LPC : LARAMIE, WY

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General NPI Number Information
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    NPI Number           |    1790198729
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    Entity Type          |    Individual 
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    Provider Name        |    DEB SMITH LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/06/2014
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    Last Update Date     |    03/10/2022
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Provider Practice Location Address
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    Address Line         |    217 E GRAND AVE UNIT 2 
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    City                 |    LARAMIE
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    State                |    WY
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    Zip                  |    82070-3604
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    Country              |    US
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    Telephone            |    307-223-6110
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2417 
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    City                 |    CHEYENNE
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    State                |    WY
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    Zip                  |    82003-2417
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    Country              |    US
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    Telephone            |    307-223-6110
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    LPC-1724
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    License Number State |    WY
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Taxonomy #2
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    PPC 734
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    License Number State |    WY
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