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NPI 1841090958

NPI 1841090958 : MS. NATTAWAN SUWANNIMIT : NORTH EAST, MD

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General NPI Number Information
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    NPI Number           |    1841090958
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    Entity Type          |    Individual 
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    Provider Name        |    MS. NATTAWAN SUWANNIMIT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/17/2025
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    Last Update Date     |    03/17/2025
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Provider Practice Location Address
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    Address Line         |    102 E CECIL AVE 
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    City                 |    NORTH EAST
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    State                |    MD
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    Zip                  |    21901-4057
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    Country              |    US
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    Telephone            |    302-897-2795
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    410 W FURROW LN 
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    City                 |    NEWARK
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    State                |    DE
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    Zip                  |    19702-4850
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    32842
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    License Number State |    MD
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