{
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"FirstLineMailingAddress": "PO BOX 1383",
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"MailingAddressStateName": "SC",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1780 TIMMONSVILLE HWY",
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"EnumerationDate": "02/04/2021",
"LastUpdateDate": "02/04/2021",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "HOLT",
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"AuthorizedOfficialTelephoneNumber": "843-309-6259",
"Taxonomies": {
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"TaxonomyName": "Early Intervention Provider Agency",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}