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NPI 1942337241

NPI 1942337241 : CAROL R. RASMUSSEN LAC : SIDNEY, MT

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General NPI Number Information
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    NPI Number           |    1942337241
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    Entity Type          |    Individual 
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    Provider Name        |    CAROL R. RASMUSSEN LAC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/27/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    209 2ND ST SE 
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    City                 |    SIDNEY
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    State                |    MT
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    Zip                  |    59270-4305
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    Country              |    US
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    Telephone            |    406-433-4097
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1818 27TH ST W 
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    City                 |    WILLISTON
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    State                |    ND
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    Zip                  |    58801-2408
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    Country              |    US
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    Telephone            |    701-774-0686
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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        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    1055
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    License Number State |    MT
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