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General NPI Number Information
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NPI Number | 1811896392
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Entity Type | Organization
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Legal Business Name | OLIVE BRANCH COUNSELING
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 2539 CHANNING WAY STE 102
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7557
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Country | US
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Telephone | 208-541-1451
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Fax | 208-875-7384
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Provider Business Mailing Address
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Address Line | 2539 CHANNING WAY STE 102
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7557
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Country | US
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Telephone | 208-541-1451
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Fax | 208-875-7384
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Authorized Official
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Title or Position | OWNER
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Name | SUSANNAH PIPKIN
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Credential | PHD
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Telephone | 208-541-1451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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