Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Children |
283XC2000X |
| NPI Number | 1679702526 |
| Entity | Organization |
| Organization subpart 1 | Not specified |
| Enumeration date | 07/13/2009 |
| Last updated | 05/17/2017 - About 9 years ago |
| Identifiers | n/a |
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LAUREN M HARRELL
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