{
"Npi": {
"NPI": "1144937079",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WILSON",
"FirstName": "ALMONYONNA",
"MiddleName": "KENYETTE",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "MASSAGE THERAPIST",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WILSON",
"OtherFirstName": "ALMONYONNA",
"OtherMiddleName": "KENYETTE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MASSAGE THERAPISTS",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "7151 W INDIAN SCHOOL RD APT 2111",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85033-3163",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-386-4287",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3001 W INDIAN SCHOOL RD STE 312A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHOENIX",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85017-4111",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "480-750-9588",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/31/2022",
"LastUpdateDate": "10/31/2022",
"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": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MT-23194",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}