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General NPI Number Information
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NPI Number | 1902043813
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Entity Type | Individual
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Provider Name | DANA MANSOUR REID D.O.
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Gender | Female
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 04/04/2018
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Provider Practice Location Address
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Address Line | 5755 NORTH POINT PARKWAY SUITE 67
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City | ALPHARETTA
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State | GA
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Zip | 30022
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Country | US
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Telephone | 770-212-2249
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Fax | 770-212-2253
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Provider Business Mailing Address
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Address Line | 5755 NORTH POINT PARKWAY SUITE 67
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City | ALPHARETTA
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State | GA
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Zip | 30022
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Country | US
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Telephone | 770-212-2249
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Fax | 770-212-2253
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 065790
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License Number State | GA
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