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General NPI Number Information
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NPI Number | 1821583394
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Entity Type | Individual
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Provider Name | ABIGAIL BRUCE
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Gender | Female
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | 1200 N BARDSTOWN RD STE D
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City | MOUNT WASHINGTON
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State | KY
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Zip | 40047-7669
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Country | US
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Telephone | 502-904-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 4202 BRECKENRIDGE LN UNIT 28
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City | LOUISVILLE
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State | KY
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Zip | 40218-3776
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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 |
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State | KY
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