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NPI 1992945489

NPI 1992945489 : JIRAPORN DOW ANGSPATT MFT, ED.D : WEAVERVILLE, CA

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General NPI Number Information
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    NPI Number           |    1992945489
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    Entity Type          |    Individual 
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    Provider Name        |    JIRAPORN DOW ANGSPATT MFT, ED.D
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/24/2009
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    Last Update Date     |    08/20/2009
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Provider Practice Location Address
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    Address Line         |    903 MAIN ST. 
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    City                 |    WEAVERVILLE
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    State                |    CA
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    Zip                  |    96093-2221
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    Country              |    US
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    Telephone            |    530-623-0462
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO 2221 
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    City                 |    WEAVERVILLE
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    State                |    CA
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    Zip                  |    96093-2221
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    Country              |    US
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    Telephone            |    530-623-0462
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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        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    MPC46529
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    License Number State |    CA
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