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General NPI Number Information
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NPI Number | 1972513299
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Entity Type | Individual
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Provider Name | VICTORIA CALVINA KELLY MD
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3125 TRANSVERSE DR.
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City | TOLEDO
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State | OH
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Zip | 43614-5811
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Country | US
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Telephone | 419-383-5695
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Fax | 419-383-3032
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Provider Business Mailing Address
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Address Line | 4707 CABRIOLET LN.
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City | MAUMEE
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State | OH
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Zip | 43537
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Country | US
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Telephone | 567-455-5432
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Fax | 567-316-6444
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35086512
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License Number State | OH
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