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General NPI Number Information
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NPI Number | 1861711566
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Entity Type | Individual
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Provider Name | CLAUDETTE A. GAYNOR LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 08/06/2017
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Provider Practice Location Address
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Address Line | 4439 REGAL CT
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3829
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Country | US
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Telephone | 561-880-6220
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Fax |
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Provider Business Mailing Address
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Address Line | 4439 REGAL CT
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3829
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Country | US
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Telephone | 561-542-6305
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH10194
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License Number State | FL
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