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DOB Client Legal Guardian/Relationship to Client Southern Light Counseling SSN Pay Source Admission Date SLC HCA Provider Clin Clinical Supervisor H. C. Case Manager RST Worker Referring County CD Vendor 002344001 SLC NPI 1346513744 Property of SLC Copying without permission is prohibited MISSED SESSION Record of Missed Session Missed/Canceled Session Scheduled Date of Service Scheduled Unit s Service Scheduled o Client No Show o Provider was present for scheduled session Drive time o...

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