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Individual
KABITA ROY
Active
Individual
KABITA ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD RN
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
LP 5514
MN
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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