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General NPI Number Information
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NPI Number | 1942892286
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Entity Type | Organization
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Legal Business Name | TLC THERAPY, LLC
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 4705 S APOPKA VINELAND RD STE 100
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City | ORLANDO
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State | FL
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Zip | 32819-3151
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Country | US
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Telephone | 404-974-9919
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Fax |
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Provider Business Mailing Address
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Address Line | 15245 SHADY GROVE RD STE 110
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City | ROCKVILLE
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State | MD
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Zip | 20850-7202
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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 | CEO
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Name | TAYLOR J DAVIDSON
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Credential |
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Telephone | 404-974-9919
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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