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General NPI Number Information
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NPI Number | 1841485653
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Entity Type | Individual
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Provider Name | JULIE BALOW LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 2075 W BIG BEAVER RD SUITE 520
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City | TROY
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State | MI
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Zip | 48084-3407
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Country | US
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Telephone | 248-646-6659
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Fax |
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Provider Business Mailing Address
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Address Line | 20855 SUNNYDALE ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48081-1817
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Country | US
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Telephone | 586-899-3201
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101006372
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License Number State | MI
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