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General NPI Number Information
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NPI Number | 1821998501
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Entity Type | Organization
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Legal Business Name | THE BEAUTY ANTIDOTE CLT, LLC
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 9127 WASHAM POTTS RD
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City | CORNELIUS
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State | NC
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Zip | 28031-6107
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Country | US
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Telephone | 980-680-7557
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Fax |
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Provider Business Mailing Address
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Address Line | 9127 WASHAM POTTS RD
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City | CORNELIUS
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State | NC
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Zip | 28031-6107
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Country | US
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Telephone | 980-680-7557
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA PARKER
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Credential |
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Telephone | 980-680-7557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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