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1255932299 NPI number — MICHELE MAY CLARK LAC

NPI Number: 1255932299
Health Care Provider/Practitioner: MICHELE MAY CLARK LAC

Information about “1255932299” NPI (MICHELE MAY CLARK LAC) exists in 1255932299 in HTML format HTML  |  1255932299 in plain Text format TXT  |  1255932299 in PDF (Portable Document Format) PDF  |  1255932299 in an XML format XML  formats.

NPI Number : 1255932299 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255932299",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CLARK",
    "FirstName": "MICHELE",
    "MiddleName": "MAY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LAC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CLARK",
    "OtherFirstName": "KARAN",
    "OtherMiddleName": "MICHELE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LAC",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "10800 FINANCIAL CENTRE PKWY STE 290",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LITTLE ROCK",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "72211-3581",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "501-781-2230",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "10800 FINANCIAL CENTRE PKWY STE 290",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LITTLE ROCK",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "72211-3581",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "501-781-2230",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/05/2020",
    "LastUpdateDate": "11/05/2020",
    "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": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "A2002020",
        "LicenseNumberStateCode": "AR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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