{
"Npi": {
"NPI": "1598806853",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CROWDER-WILE",
"FirstName": "MARILYN",
"MiddleName": "THERESA",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "MS CCC-SLP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CROWDER",
"OtherFirstName": "MARILYN",
"OtherMiddleName": "THERESA",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "MS CFY-SLP",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "4104 7TH PL NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROCHESTER",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55901-8454",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "507-281-3001",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2746 SUPERIOR DR NW",
"SecondLinePracticeLocationAddress": "SUITE 300",
"PracticeLocationAddressCityName": "ROCHESTER",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55901-8343",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "507-288-0064",
"PracticeLocationAddressFaxNumber": "507-288-3993",
"EnumerationDate": "02/09/2007",
"LastUpdateDate": "07/08/2007",
"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": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "6018",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}