{
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"EIN": null,
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"FirstLineMailingAddress": "4410 W CACTUS RD",
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"MailingAddressCityName": "GLENDALE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85304-2338",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "602-938-5087",
"MailingAddressFaxNumber": "602-938-6293",
"FirstLinePracticeLocationAddress": "4410 W CACTUS RD",
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"PracticeLocationAddressTelephoneNumber": "602-938-5087",
"PracticeLocationAddressFaxNumber": "602-938-6293",
"EnumerationDate": "03/13/2010",
"LastUpdateDate": "03/13/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Pharmacist",
"LicenseNumber": "S013296",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}