{
"Npi": {
"NPI": "1336311257",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "AJAYI-NABORS",
"FirstName": "MARGARET",
"MiddleName": "O",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PHP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "AJAYI",
"OtherFirstName": "MARGARET",
"OtherMiddleName": "O",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1400 W MILHAM AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORTAGE",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49024-1209",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "269-312-8686",
"MailingAddressFaxNumber": "269-220-5333",
"FirstLinePracticeLocationAddress": "350 E MICHIGAN AVE",
"SecondLinePracticeLocationAddress": "SUITE 135",
"PracticeLocationAddressCityName": "KALAMAZOO",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49007-3800",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "269-206-1480",
"PracticeLocationAddressFaxNumber": "269-366-4946",
"EnumerationDate": "03/31/2008",
"LastUpdateDate": "11/29/2017",
"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": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "6301012355",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}