{
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"FirstLineMailingAddress": "62 IMPERIAL DR",
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"MailingAddressCityName": "MILLER PLACE",
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"FirstLinePracticeLocationAddress": "44 ELM ST STE 10",
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"PracticeLocationAddressCityName": "HUNTINGTON",
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"EnumerationDate": "05/16/2019",
"LastUpdateDate": "09/30/2020",
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Speech-Language Pathologist",
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"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}