{
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"FirstLineMailingAddress": "714 VENTURE DR # 216",
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"MailingAddressFaxNumber": "304-292-1890",
"FirstLinePracticeLocationAddress": "714 VENTURE DR # 216",
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"PracticeLocationAddressFaxNumber": "304-292-1890",
"EnumerationDate": "04/23/2007",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
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"TaxonomyName": "Case Manager/Care Coordinator",
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"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}