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General NPI Number Information
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NPI Number | 1831028232
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Entity Type | Individual
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Provider Name | KELLI LYNN DOUVILLE
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Gender | Female
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 1001 FOURIER DR STE 200
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City | MADISON
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State | WI
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Zip | 53717-1958
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Country | US
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Telephone | 608-740-2001
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Fax |
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Provider Business Mailing Address
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Address Line | 1034 BLUEBIRD LN
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City | HARTFORD
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State | WI
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Zip | 53027-2791
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3020-57
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License Number State | WI
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