{
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"FirstLineMailingAddress": "25 HALL RD",
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"MailingAddressCityName": "LONDONDERRY",
"MailingAddressStateName": "NH",
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"MailingAddressTelephoneNumber": "603-490-3244",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "145 HOLLIS ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MANCHESTER",
"PracticeLocationAddressStateName": "NH",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "603-626-9500",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/03/2020",
"LastUpdateDate": "04/03/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"AuthorizedOfficialCredential": null,
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Nutritionist",
"LicenseNumber": "LDN00354",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}