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General NPI Number Information
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NPI Number | 1902351612
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Entity Type | Organization
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Legal Business Name | SYNERGY THERAPY, INC.
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 1605 HOPE ST SUITE 300
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-2628
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Country | US
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Telephone | 626-537-9797
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Fax |
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Provider Business Mailing Address
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Address Line | 333 W GARVEY AVE STE 735
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City | MONTEREY PARK
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State | CA
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Zip | 91754-7430
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Country | US
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Telephone | 626-537-9797
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MONA GONZALES
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Credential |
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Telephone | 626-537-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 10785
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License Number State | CA
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