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ALLIED REHAB HOSPITAL 475 Morgan Highway, P.O. Box 1103 Scranton, PA 185011103 Phone: (570) 3481300 TDD: (570) 3481240 www.alliedservices.orgAUTHORIZATION FOR RELEASE OF PSYCHIATRIC/PSYCHOLOGICAL
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Box 1103 Scranton PA 18501-1103 template is a specific form or document used for reporting certain information to the designated recipient at that specific address.
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