{
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"FirstLineMailingAddress": "29 E 2120 N",
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"MailingAddressCityName": "PROVO",
"MailingAddressStateName": "UT",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1190 N 900 E",
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"PracticeLocationAddressTelephoneNumber": "801-422-7620",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/20/2008",
"LastUpdateDate": "05/20/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "6310808-3904",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}