{
"Npi": {
"NPI": "1497495022",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WADE",
"FirstName": "HANNAH",
"MiddleName": "RUTHANN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.ED, BCBA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1165 SHADOW GLENN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CONROE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77301-2258",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "832-671-9539",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2174 N FM-3083 RD W",
"SecondLinePracticeLocationAddress": "SUITE 300",
"PracticeLocationAddressCityName": "CONROE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77304",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "936-315-3787",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/31/2022",
"LastUpdateDate": "03/06/2025",
"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": "106S00000X",
"TaxonomyName": "Behavior Technician",
"LicenseNumber": "RBT-22-209646",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103K00000X",
"TaxonomyName": "Behavior Analyst",
"LicenseNumber": "1-25-79600",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}