{
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"FirstLineMailingAddress": "688 ANTELOPE GAP RD",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "688 ANTELOPE GAP RD",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/05/2021",
"LastUpdateDate": "01/22/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BELKNAP-WILLIAMS",
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"AuthorizedOfficialCredential": "LPC",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}