{
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"FirstLineMailingAddress": "5132 MIMOSA DR",
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"EnumerationDate": "05/14/2013",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "WAGNER",
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"AuthorizedOfficialCredential": "M.A., ED.M., L.P.C.",
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"Taxonomy": {
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}
},
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}
}
}
}