1447514617 NPI number — MALERIE D MASON M.A., CCC-SLP

NPI Number: 1447514617
Health Care Provider/Practitioner: MALERIE D MASON M.A., CCC-SLP

NPI Number : 1447514617 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1447514617",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MASON",
    "FirstName": "MALERIE",
    "MiddleName": "D",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.A., CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "403 MAPLE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MARSHALL",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "62441-1169",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1011 N MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PARIS",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "61944-1145",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "217-465-5376",
    "PracticeLocationAddressFaxNumber": "217-465-8106",
    "EnumerationDate": "07/02/2012",
    "LastUpdateDate": "07/02/2012",
    "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": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "146.009802",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "22005342A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}