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General NPI Number Information
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NPI Number | 1871140467
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Entity Type | Individual
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Provider Name | KIMBERLY A LEE MS CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 550 MAIN ST
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City | MASHPEE
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State | MA
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Zip | 02649-2048
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Country | US
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Telephone | 508-539-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 150 TRURO LN
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City | MILTON
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State | MA
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Zip | 02186-2655
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Country | US
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Telephone | 617-686-0886
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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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 4029
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License Number State | MA
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