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General NPI Number Information
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NPI Number | 1912562380
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Entity Type | Individual
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Provider Name | CRYSTAL DAY MA
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Gender | Female
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Dates
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Enumeration Date | 05/01/2019
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Last Update Date | 02/10/2024
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Provider Practice Location Address
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Address Line | 2008 E FINCH DR
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City | TONGANOXIE
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State | KS
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Zip | 66086-9718
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Country | US
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Telephone | 913-732-1824
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Fax |
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Provider Business Mailing Address
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Address Line | 2008 E FINCH DR
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City | TONGANOXIE
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State | KS
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Zip | 66086-9718
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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