{
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"FirstLineMailingAddress": "6434 N SHORE BND",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RICHMOND",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77469-9261",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "9210 HIGHWAY 6 S",
"SecondLinePracticeLocationAddress": "SUITE C",
"PracticeLocationAddressCityName": "HOUSTON",
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"PracticeLocationAddressTelephoneNumber": "281-575-1220",
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"EnumerationDate": "07/16/2010",
"LastUpdateDate": "07/16/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LABRIE",
"AuthorizedOfficialFirstName": "MONICA",
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"AuthorizedOfficialTitle": "CO-OWNER/BEHAVIOR ANALYST",
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"AuthorizedOfficialCredential": "BCBA",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103K00000X",
"TaxonomyName": "Behavior Analyst",
"LicenseNumber": "1-07-3585",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}