{
"Npi": {
"NPI": "1164229274",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CORY",
"FirstName": "CHRISTINA",
"MiddleName": "MILYNNNE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2101 N FREMONT AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPRINGFIELD",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "65803-4050",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "417-455-6136",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "101 E ELLA ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VERONA",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "65769-5213",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "833-402-9580",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/26/2025",
"LastUpdateDate": "02/26/2025",
"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": "2355S0801X",
"TaxonomyName": "Speech-Language Assistant",
"LicenseNumber": "2022038429",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}