{
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"NameSuffix": null,
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"OtherCredential": "MA",
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"FirstLineMailingAddress": "94-828 LUMIAUAU ST",
"SecondLineMailingAddress": "M204",
"MailingAddressCityName": "WAIPAHU",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96797-4861",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-354-2187",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "94-828 LUMIAUAU ST",
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"PracticeLocationAddressCityName": "WAIPAHU",
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"PracticeLocationAddressPostalCode": "96797",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-354-2187",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/16/2014",
"LastUpdateDate": "06/16/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "05/30/2018",
"NPIReactivationDate": "06/06/2018",
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
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"AuthorizedOfficialTitle": null,
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MFT-563",
"LicenseNumberStateCode": "HI",
"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."
}
}
}
}