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1487370748 NPI number — MELISSA SUE GRABLER

NPI Number: 1487370748
Health Care Provider/Practitioner: MELISSA SUE GRABLER

Information about “1487370748” NPI (MELISSA SUE GRABLER) exists in 1487370748 in HTML format HTML  |  1487370748 in plain Text format TXT  |  1487370748 in PDF (Portable Document Format) PDF  |  1487370748 in an XML format XML  formats.

NPI Number : 1487370748 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487370748",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GRABLER",
    "FirstName": "MELISSA",
    "MiddleName": "SUE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BOISSONNEAULT",
    "OtherFirstName": "MELISSA",
    "OtherMiddleName": "GRABLER",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "OTR/L",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "76 CLEMONS ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SOUTH PORTLAND",
    "MailingAddressStateName": "ME",
    "MailingAddressPostalCode": "04106-3705",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "207-807-6195",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "357 TUTTLE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CUMBERLAND CENTER",
    "PracticeLocationAddressStateName": "ME",
    "PracticeLocationAddressPostalCode": "04021-3625",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "207-829-4800",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/18/2022",
    "LastUpdateDate": "10/18/2022",
    "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": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "OT4141",
        "LicenseNumberStateCode": "ME",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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