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1598016560 NPI number — CAROLYN JILL BARYLAK OT

NPI Number: 1598016560
Health Care Provider/Practitioner: CAROLYN JILL BARYLAK OT

Information about “1598016560” NPI (CAROLYN JILL BARYLAK OT) exists in 1598016560 in HTML format HTML  |  1598016560 in plain Text format TXT  |  1598016560 in PDF (Portable Document Format) PDF  |  1598016560 in an XML format XML  formats.

NPI Number : 1598016560 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1598016560",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BARYLAK",
    "FirstName": "CAROLYN",
    "MiddleName": "JILL",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "OT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PHILLIPS",
    "OtherFirstName": "CAROLYN",
    "OtherMiddleName": "JILL",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "OT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "4925 CHELTENHAM PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CUMMING",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30041-5818",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "404-217-0785",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11405 MEDLOCK BRIDGE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JOHNS CREEK",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30097-1688",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "770-814-0505",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/30/2012",
    "LastUpdateDate": "09/30/2012",
    "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": "OT003014",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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