{
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"LastName": "CLIFFORD",
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"FirstLineMailingAddress": "PO BOX 871",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHARLESTON",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72933-0871",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "479-965-6752",
"MailingAddressFaxNumber": "479-965-2612",
"FirstLinePracticeLocationAddress": "42 E MAIN ST",
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"PracticeLocationAddressCityName": "BOONEVILLE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "479-965-6752",
"PracticeLocationAddressFaxNumber": "870-451-0222",
"EnumerationDate": "01/23/2007",
"LastUpdateDate": "07/10/2024",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Pediatric Occupational Therapist",
"LicenseNumber": "OTR861",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}