{
"Npi": {
"NPI": "1336603471",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GROSSO",
"FirstName": "DOLORES",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "PULINKO",
"OtherFirstName": "DOLORES",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "OTR/L",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "6740 SWAN CREEK RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FAIR HAVEN",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48023",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "586-725-1792",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4100 RIVER RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EAST CHINA",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48054-2909",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "810-329-5385",
"PracticeLocationAddressFaxNumber": "810-329-8919",
"EnumerationDate": "01/23/2019",
"LastUpdateDate": "01/23/2019",
"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": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "5201003223",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}