{
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"FirstLineMailingAddress": "1772 E BOSTON ST",
"SecondLineMailingAddress": "SUITE 107",
"MailingAddressCityName": "GILBERT",
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"MailingAddressPostalCode": "85295-6242",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-649-6499",
"MailingAddressFaxNumber": "480-207-2580",
"FirstLinePracticeLocationAddress": "1772 E BOSTON ST",
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"PracticeLocationAddressCityName": "GILBERT",
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"PracticeLocationAddressTelephoneNumber": "480-649-6499",
"PracticeLocationAddressFaxNumber": "480-207-2580",
"EnumerationDate": "05/25/2016",
"LastUpdateDate": "05/25/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEAZER",
"AuthorizedOfficialFirstName": "RUSSELL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER / PSYCHOTHERAPIST",
"AuthorizedOfficialNamePrefix": "MR.",
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"AuthorizedOfficialCredential": "MS LMFT",
"AuthorizedOfficialTelephoneNumber": "480-649-6499",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "LMFT10047",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}