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General NPI Number Information
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NPI Number | 1841585734
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Entity Type | Individual
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Provider Name | AMY N MOONEY PH.D., LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/18/2011
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Last Update Date | 08/05/2015
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Provider Practice Location Address
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Address Line | 1103 BUCKEYE AVE SUITE 104
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City | AMES
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State | IA
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Zip | 50010-8120
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Country | US
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Telephone | 515-337-1380
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Fax | 855-377-6321
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Provider Business Mailing Address
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Address Line | 809 WHEELER ST STE 110 BOX 380
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City | AMES
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State | IA
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Zip | 50010-4367
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Country | US
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Telephone | 515-450-1989
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 00933
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License Number State | IA
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