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1144599556 NPI number — ANNA RICHELLE BRISTLE MS, LLPC

NPI Number: 1144599556
Health Care Provider/Practitioner: ANNA RICHELLE BRISTLE MS, LLPC

Information about “1144599556” NPI (ANNA RICHELLE BRISTLE MS, LLPC) exists in 1144599556 in HTML format HTML  |  1144599556 in plain Text format TXT  |  1144599556 in PDF (Portable Document Format) PDF  |  1144599556 in an XML format XML  formats.

NPI Number : 1144599556 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144599556",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRISTLE",
    "FirstName": "ANNA",
    "MiddleName": "RICHELLE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MS, LLPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "OLMSTEAD",
    "OtherFirstName": "ANNA",
    "OtherMiddleName": "RICHELLE",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "103 ARNET ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "YPSILANTI",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48198-5706",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "734-961-1990",
    "MailingAddressFaxNumber": "734-961-1996",
    "FirstLinePracticeLocationAddress": "103 ARNET ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "YPSILANTI",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48198-5706",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "734-961-1990",
    "PracticeLocationAddressFaxNumber": "734-961-1996",
    "EnumerationDate": "12/14/2011",
    "LastUpdateDate": "06/07/2012",
    "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": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "6401012788",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "171M00000X",
          "TaxonomyName": "Case Manager/Care Coordinator",
          "LicenseNumber": "6803085177",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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