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General NPI Number Information
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NPI Number | 1881829612
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Entity Type | Organization
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Legal Business Name | KALEIDOKIDZ THERAPY, LLC
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 12/30/2009
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Provider Practice Location Address
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Address Line | 5507 BRADFORD ESTATES CT
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City | SACHSE
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State | TX
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Zip | 75048-3426
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Country | US
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Telephone | 972-442-9292
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Fax | 214-269-5981
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Provider Business Mailing Address
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Address Line | PO BOX 872032
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City | MESQUITE
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State | TX
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Zip | 75187-2032
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Country | US
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Telephone | 972-442-9292
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Fax | 214-269-5981
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | DIANA MARSHALL
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Credential | PT
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Telephone | 972-442-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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