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General NPI Number Information
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NPI Number | 1912927567
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Entity Type | Individual
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Provider Name | DIANE M STAUFFER M.S.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 04/10/2019
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Provider Practice Location Address
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Address Line | 517 DELTONA BLVD STE A
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City | DELTONA
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State | FL
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Zip | 32725-8016
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Country | US
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Telephone | 386-238-3830
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Fax |
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Provider Business Mailing Address
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Address Line | 68 VIRGINIA AVE
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City | DELAND
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State | FL
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Zip | 32724-1314
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Country | US
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Telephone | 386-837-5415
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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