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General NPI Number Information
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NPI Number | 1881626521
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Entity Type | Individual
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Provider Name | STUART J. GREIF PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6700 S FLORIDA AVE SUITE 13
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City | LAKELAND
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State | FL
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Zip | 33813-3327
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Country | US
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Telephone | 863-648-0500
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Fax | 863-644-9015
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Provider Business Mailing Address
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Address Line | 4301 E KNIGHTS GRIFFIN RD
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City | PLANT CITY
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State | FL
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Zip | 33565-2217
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Country | US
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Telephone | 813-754-1105
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY 3817
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License Number State | FL
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