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General NPI Number Information
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NPI Number | 1942514765
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Entity Type | Individual
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Provider Name | AMANDA SCHURLE BRUCE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 3901 RAINBOW BLVD
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City | KANSAS CITY
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State | KS
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Zip | 66103-2937
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Country | US
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Telephone | 913-588-5928
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Fax |
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Provider Business Mailing Address
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Address Line | 5030 CHERRY ST #307
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City | KANSAS CITY
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State | MO
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Zip | 64110-2232
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Country | US
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Telephone | 816-235-6101
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1962
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License Number State | KS
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