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1104392059 NPI number — LYNETTE TERSKA

NPI Number: 1104392059
Health Care Provider/Practitioner: LYNETTE TERSKA

Information about “1104392059” NPI (LYNETTE TERSKA) exists in 1104392059 in HTML format HTML  |  1104392059 in plain Text format TXT  |  1104392059 in PDF (Portable Document Format) PDF  |  1104392059 in an XML format XML  formats.

NPI Number : 1104392059 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104392059",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TERSKA",
    "FirstName": "LYNETTE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TERSKA",
    "OtherFirstName": "LYNETTE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MCCLUSTER",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "7565 E US HIGHWAY 66",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EL RENO",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "73036-9120",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "405-262-6555",
    "MailingAddressFaxNumber": "--",
    "FirstLinePracticeLocationAddress": "7565 E US HIGHWAY 66",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EL RENO",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "73036-9120",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "405-262-6555",
    "PracticeLocationAddressFaxNumber": "--",
    "EnumerationDate": "10/18/2018",
    "LastUpdateDate": "08/20/2025",
    "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": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106S00000X",
          "TaxonomyName": "Behavior Technician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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