{
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"FirstLineMailingAddress": "308 BARNSTABLE QUAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VIRGINIA BEACH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23452-8002",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "308 BARNSTABLE QUAY",
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"EnumerationDate": "07/11/2011",
"LastUpdateDate": "07/11/2011",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PEPRAH",
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"AuthorizedOfficialCredential": "MSW",
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"TaxonomyName": "Community/Behavioral Health Agency",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}