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1174651384 NPI number — LESLIE ANN CAPETILLO O.T.

NPI Number: 1174651384
Health Care Provider/Practitioner: LESLIE ANN CAPETILLO O.T.

Information about “1174651384” NPI (LESLIE ANN CAPETILLO O.T.) exists in 1174651384 in HTML format HTML  |  1174651384 in plain Text format TXT  |  1174651384 in PDF (Portable Document Format) PDF  |  1174651384 in an XML format XML  formats.

NPI Number : 1174651384 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174651384",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CAPETILLO",
    "FirstName": "LESLIE",
    "MiddleName": "ANN",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "O.T.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "AMBROSIUS",
    "OtherFirstName": "LESLIE",
    "OtherMiddleName": "ANN",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "O.T.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1430 COLLIER ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AUSTIN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78704-2911",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "512-445-7787",
    "MailingAddressFaxNumber": "512-440-4059",
    "FirstLinePracticeLocationAddress": "1717 W 10TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "AUSTIN",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78703-3907",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "512-804-3100",
    "PracticeLocationAddressFaxNumber": "512-472-3103",
    "EnumerationDate": "03/01/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "110773",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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