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NPI 1902475601

NPI 1902475601 : KAITLYN GARRETT : DUBLIN, OH

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General NPI Number Information
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    NPI Number           |    1902475601
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    Entity Type          |    Individual 
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    Provider Name        |    KAITLYN GARRETT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/18/2021
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    Last Update Date     |    06/18/2021
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Provider Practice Location Address
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    Address Line         |    5940 VENTURE DR STE A 
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    City                 |    DUBLIN
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    State                |    OH
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    Zip                  |    43017-2246
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    Country              |    US
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    Telephone            |    937-210-6691
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    202 W 8TH AVE 
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    City                 |    COLUMBUS
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    State                |    OH
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    Zip                  |    43201-2312
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    Country              |    US
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    Telephone            |    
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    S.2106169
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    License Number State |    OH
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