{
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"FirstLineMailingAddress": "2715D GRANDVIEW AVE # 237",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "515 COLLEGE RD STE 13",
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"PracticeLocationAddressCityName": "GREENSBORO",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/11/2019",
"LastUpdateDate": "06/17/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARKS",
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"AuthorizedOfficialCredential": "M.S., CCC-SLP",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Speech-Language Pathologist",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}