{
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"FirstLineMailingAddress": "3007 BARDWELL RD",
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"MailingAddressCityName": "GREENSBORO",
"MailingAddressStateName": "NC",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "3007 BARDWELL RD",
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"PracticeLocationAddressCityName": "GREENSBORO",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "336-287-7353",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/31/2006",
"LastUpdateDate": "04/25/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "869",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}