{
"Npi": {
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"EIN": null,
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"LastName": "NYANGWARA",
"FirstName": "CHARLES",
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"NamePrefix": "MR.",
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"Credential": "VR COUNSELOR",
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"OtherCredential": null,
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"FirstLineMailingAddress": "220 LAKE ARROWHEAD CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BEAR",
"MailingAddressStateName": "DE",
"MailingAddressPostalCode": "19701-1796",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "302-252-1271",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3900 WOODLAND AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHILADELPHIA",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19104-4551",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-823-5800",
"PracticeLocationAddressFaxNumber": "215-823-4610",
"EnumerationDate": "11/21/2023",
"LastUpdateDate": "11/21/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
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"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225C00000X",
"TaxonomyName": "Rehabilitation Counselor",
"LicenseNumber": "105112",
"LicenseNumberStateCode": "DE",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}