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NPI 1912160417

NPI 1912160417 : TINA Z FLEISHMAN PSY. D. : AVON, CO

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General NPI Number Information
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    NPI Number           |    1912160417
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    Entity Type          |    Individual 
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    Provider Name        |    TINA Z FLEISHMAN PSY. D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/03/2008
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    Last Update Date     |    07/03/2008
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Provider Practice Location Address
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    Address Line         |    30 BENCHMARK ROAD SUITE 224
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    City                 |    AVON
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    State                |    CO
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    Zip                  |    81620
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    Country              |    US
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    Telephone            |    970-476-8032
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    Fax                  |    970-476-3654
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Provider Business Mailing Address
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    Address Line         |    PO BOX 4242 
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    City                 |    VAIL
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    State                |    CO
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    Zip                  |    81658-4242
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    Country              |    US
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    Telephone            |    970-476-8032
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    Fax                  |    970-476-3654
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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        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    1022
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    License Number State |    CO
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