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General NPI Number Information
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NPI Number | 1942100797
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Entity Type | Individual
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Provider Name | MARY CAMPBELL
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Gender |
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 6280 POST RD
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City | CUMMING
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State | GA
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Zip | 30040-7378
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Country | US
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Telephone | 770-346-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 8 WATERFRONT SQ
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City | DAWSONVILLE
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State | GA
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Zip | 30534-5774
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP004601
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License Number State | GA
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