{
"Npi": {
"NPI": "1043756174",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HESSER",
"FirstName": "MARIBETH",
"MiddleName": "L.",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PSY.D",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HESSER",
"OtherFirstName": "BETSY",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PSY.D",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "6675 N UPPER CASCADE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JACKSON",
"MailingAddressStateName": "WY",
"MailingAddressPostalCode": "83001-9390",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "307-690-3043",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6675 N UPPER CASCADE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JACKSON",
"PracticeLocationAddressStateName": "WY",
"PracticeLocationAddressPostalCode": "83001-9390",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "307-690-3043",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/12/2017",
"LastUpdateDate": "01/12/2017",
"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": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "387",
"LicenseNumberStateCode": "WY",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "103TC2200X",
"TaxonomyName": "Clinical Child & Adolescent Psychologist",
"LicenseNumber": "387",
"LicenseNumberStateCode": "WY",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}