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1013441708 NPI number — TRACIE CAROLE DANIEL SLP

NPI Number: 1013441708
Health Care Provider/Practitioner: TRACIE CAROLE DANIEL SLP

Information about “1013441708” NPI (TRACIE CAROLE DANIEL SLP) exists in 1013441708 in HTML format HTML  |  1013441708 in plain Text format TXT  |  1013441708 in PDF (Portable Document Format) PDF  |  1013441708 in an XML format XML  formats.

NPI Number : 1013441708 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1013441708",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DANIEL",
    "FirstName": "TRACIE",
    "MiddleName": "CAROLE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5121 JACQUELYN LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BARTLESVILLE",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "74006-7723",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "918-335-3005",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5121 JACQUELYN LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BARTLESVILLE",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "74006-7723",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "918-335-3005",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/19/2017",
    "LastUpdateDate": "04/19/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "2132",
        "LicenseNumberStateCode": "OK",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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