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NPI 1891029062

NPI 1891029062 : A NEW INSPIRATION : MARTINSVILLE, VA

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General NPI Number Information
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    NPI Number           |    1891029062
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    Entity Type          |    Organization 
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    Legal Business Name  |    A NEW INSPIRATION 
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Dates
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    Enumeration Date     |    09/21/2009
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    Last Update Date     |    09/21/2009
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Provider Practice Location Address
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    Address Line         |    6 E MAIN ST 
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    City                 |    MARTINSVILLE
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    State                |    VA
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    Zip                  |    24112-2720
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    Country              |    US
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    Telephone            |    336-776-7631
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    Fax                  |    336-722-4499
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Provider Business Mailing Address
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    Address Line         |    6 E MAIN ST 
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    City                 |    MARTINSVILLE
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    State                |    VA
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    Zip                  |    24112-2720
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    Country              |    US
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    Telephone            |    336-776-7631
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    Fax                  |    336-722-4499
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MR. MITCHELL KENDELL BROWN 
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    Credential           |    
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    Telephone            |    336-776-7631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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