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General NPI Number Information
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NPI Number | 1952201675
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Entity Type | Individual
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Provider Name | JOENIQUE GERALDINE ACOSTA
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Gender | Female
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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 | 327 W GORDON AVE STE 1
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City | LAYTON
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State | UT
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Zip | 84041-2381
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Country | US
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Telephone | 801-452-1940
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Fax |
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Provider Business Mailing Address
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Address Line | 780 W 2350 N
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City | LAYTON
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State | UT
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Zip | 84041-4768
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Country | US
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Telephone | 385-306-0902
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 255891475
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License Number State | UT
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