NPI Code Detail JSON Logo

1205112802 NPI number — MICHELLE DELEONE-THOMAS GUTTENPLAN CCC-SLP

NPI Number: 1205112802
Health Care Provider/Practitioner: MICHELLE DELEONE-THOMAS GUTTENPLAN CCC-SLP

Information about “1205112802” NPI (MICHELLE DELEONE-THOMAS GUTTENPLAN CCC-SLP) exists in 1205112802 in HTML format HTML  |  1205112802 in plain Text format TXT  |  1205112802 in PDF (Portable Document Format) PDF  |  1205112802 in an XML format XML  formats.

NPI Number : 1205112802 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205112802",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GUTTENPLAN",
    "FirstName": "MICHELLE",
    "MiddleName": "DELEONE-THOMAS",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "THOMAS",
    "OtherFirstName": "MICHELLE",
    "OtherMiddleName": "DELEONE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "100 N MARIO CAPECCHI DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SALT LAKE CITY",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84113-1103",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6135 ROOSEVELT HWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WARM SPRINGS",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "31830-1000",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "706-655-5432",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/26/2011",
    "LastUpdateDate": "11/06/2019",
    "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": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "PCET001697",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "9064857-4102",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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