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NPI 1972117273

NPI 1972117273 : 2ORMOREDIRECTION, LLC. : MACON, GA

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General NPI Number Information
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    NPI Number           |    1972117273
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    Entity Type          |    Organization 
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    Legal Business Name  |    2ORMOREDIRECTION, LLC. 
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Dates
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    Enumeration Date     |    09/03/2020
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    Last Update Date     |    09/03/2020
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Provider Practice Location Address
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    Address Line         |    444 FOREST HILL RD APT 612 
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    City                 |    MACON
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    State                |    GA
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    Zip                  |    31210-4834
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    Country              |    US
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    Telephone            |    888-451-8912
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    444 FOREST HILL RD APT 612 
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    City                 |    MACON
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    State                |    GA
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    Zip                  |    31210-4834
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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                 |     MONICA  BLALOCK 
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    Credential           |    
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    Telephone            |    678-914-7293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    
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    License Number State |    
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