{
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"FirstLineMailingAddress": "2882 W LIBERTY AVE FL 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PITTSBURGH",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "15216-2622",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2882 W LIBERTY AVE FL 2",
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"PracticeLocationAddressCityName": "PITTSBURGH",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/07/2016",
"LastUpdateDate": "04/22/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHALEY",
"AuthorizedOfficialFirstName": "CARRIE",
"AuthorizedOfficialMiddleName": "FAITH",
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"AuthorizedOfficialCredential": "LMT",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MSG007904",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}