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1295131969 NPI number — MARYANNE BELTON PSY.D.

NPI Number: 1295131969
Health Care Provider/Practitioner: MARYANNE BELTON PSY.D.

Information about “1295131969” NPI (MARYANNE BELTON PSY.D.) exists in 1295131969 in HTML format HTML  |  1295131969 in plain Text format TXT  |  1295131969 in PDF (Portable Document Format) PDF  |  1295131969 in an XML format XML  formats.

NPI Number : 1295131969 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295131969",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BELTON",
    "FirstName": "MARYANNE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PSY.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5930 E PIMA ST STE 138",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TUCSON",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85712-4351",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "520-441-4006",
    "MailingAddressFaxNumber": "855-249-5320",
    "FirstLinePracticeLocationAddress": "5930 E PIMA ST STE 138",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TUCSON",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85712-4351",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "520-441-4006",
    "PracticeLocationAddressFaxNumber": "855-249-5320",
    "EnumerationDate": "11/07/2014",
    "LastUpdateDate": "03/15/2021",
    "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": "103TC0700X",
          "TaxonomyName": "Clinical Psychologist",
          "LicenseNumber": "PSY00-4572",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "4572",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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