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NPI 1881715712

NPI 1881715712 : TERESA A O'NEAL-PAYNE L.M.F.T. : ARCADIA, CA

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General NPI Number Information
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    NPI Number           |    1881715712
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    Entity Type          |    Individual 
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    Provider Name        |    TERESA A O'NEAL-PAYNE L.M.F.T.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/02/2007
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    Last Update Date     |    07/15/2008
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Provider Practice Location Address
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    Address Line         |    125 WHEELER AVE SUITE C
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    City                 |    ARCADIA
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    State                |    CA
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    Zip                  |    91006-3220
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    Country              |    US
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    Telephone            |    626-485-7446
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    125 WHEELER AVE SUITE C
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    City                 |    ARCADIA
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    State                |    CA
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    Zip                  |    91006-3220
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    Country              |    US
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    Telephone            |    626-485-7446
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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       |    MFC44907
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    License Number State |    CA
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