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1144542192
DEREK J BOUTIN
TAMPA, FL
NPI
1144542192
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2010-02-18
Last Update Date
2010-02-18
Business Address
-- DEREK J BOUTIN
5707 N 22ND ST
TAMPA, FL 33610-4350
Phone number: 813-272-2878
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Mailing Address
-- DEREK J BOUTIN
5707 N 22ND ST
TAMPA, FL 33610-4350
Phone number: 813-272-2878
Copy
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