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NPI 1962651596

NPI 1962651596 : THERAPEUTIC CONSULTING SERVICES : QUEEN CREEK, AZ

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General NPI Number Information
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    NPI Number           |    1962651596
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    Entity Type          |    Organization 
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    Legal Business Name  |    THERAPEUTIC CONSULTING SERVICES 
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Dates
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    Enumeration Date     |    09/18/2008
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    Last Update Date     |    09/18/2008
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Provider Practice Location Address
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    Address Line         |    22717 S ELLSWORTH RD B-101
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    City                 |    QUEEN CREEK
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    State                |    AZ
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    Zip                  |    85242-6127
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    Country              |    US
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    Telephone            |    480-258-2915
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    Fax                  |    480-888-0231
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1598 
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    City                 |    QUEEN CREEK
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    State                |    AZ
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    Zip                  |    85242-1598
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    Country              |    US
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    Telephone            |    480-258-2915
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    Fax                  |    480-888-0231
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MRS. PAMELA CAROL DEAN 
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    Credential           |    LCSW
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    Telephone            |    480-258-2915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    LCSW-2854
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    License Number State |    AZ
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