{
"Npi": {
"NPI": "1033437512",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MORAN",
"FirstName": "STEPHANIE",
"MiddleName": "LAUREN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "M.S. SLP-CF",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3625 MAGNOLIA AVENUE",
"SecondLineMailingAddress": "BEAUVAIS MANOR ON THE PARK",
"MailingAddressCityName": "ST LOUIS",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63110-4048",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "314-771-2990",
"MailingAddressFaxNumber": "341-771-7790",
"FirstLinePracticeLocationAddress": "3625 MAGNOLIA AVENUE",
"SecondLinePracticeLocationAddress": "BEAUVAIS MANOR ON THE PARK",
"PracticeLocationAddressCityName": "ST LOUIS",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63110-4048",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "314-771-2990",
"PracticeLocationAddressFaxNumber": "341-771-7790",
"EnumerationDate": "05/10/2010",
"LastUpdateDate": "05/10/2010",
"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": "2009030850",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}