1215408232 NPI number — PAMELA D GLATFELTER M.S. CCC-SLP

NPI Number: 1215408232
Health Care Provider/Practitioner: PAMELA D GLATFELTER M.S. CCC-SLP

NPI Number : 1215408232 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215408232",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GLATFELTER",
    "FirstName": "PAMELA",
    "MiddleName": "D",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.S. CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SUDBRINK",
    "OtherFirstName": "PAMELA",
    "OtherMiddleName": "D",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.S. CCC-SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5810 OAKDALE SCHOOL RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "IJAMSVILLE",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21754-9713",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "240-236-5570",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5810 OAKDALE SCHOOL RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "IJAMSVILLE",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21754-9713",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "240-236-5570",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/17/2018",
    "LastUpdateDate": "12/17/2018",
    "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": "06195",
        "LicenseNumberStateCode": "MD",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}