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NPI 1831466127

NPI 1831466127 : RACHEL VAN B.A. : SPARKS, NV

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General NPI Number Information
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    NPI Number           |    1831466127
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    Entity Type          |    Individual 
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    Provider Name        |    RACHEL VAN B.A.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/30/2011
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    Last Update Date     |    11/30/2011
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Provider Practice Location Address
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    Address Line         |    4255 WEDEKIND ROAD #111 
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    City                 |    SPARKS
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    State                |    NV
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    Zip                  |    89431
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    Country              |    US
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    Telephone            |    775-527-6164
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4255 WEDEKIND ROAD APT. #111 
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    City                 |    SPARKS
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    State                |    NV
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    Zip                  |    89431
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    Country              |    US
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    Telephone            |    775-527-6164
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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        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    
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