{
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"FirstLineMailingAddress": "5115 MINTVALE DR",
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"FirstLinePracticeLocationAddress": "1000 BAXTER ST",
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"EnumerationDate": "10/10/2017",
"LastUpdateDate": "12/06/2017",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "FAIR",
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"AuthorizedOfficialCredential": "PHD, LMFT",
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{
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"TaxonomyName": "Marriage & Family Therapist",
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
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}
]
}
}
}