{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "THE SPRUILL STUDIO FOR SPEECH AND VOICE, INC.",
"LastName": null,
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"NamePrefix": null,
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"Credential": null,
"OtherOrgName": null,
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"FirstLineMailingAddress": "1228 BRIDGEFORD DR NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUNTERSVILLE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28078-4328",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "704-464-0464",
"MailingAddressFaxNumber": "866-636-4063",
"FirstLinePracticeLocationAddress": "1228 BRIDGEFORD DR NW",
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"PracticeLocationAddressCityName": "HUNTERSVILLE",
"PracticeLocationAddressStateName": "NC",
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"PracticeLocationAddressTelephoneNumber": "704-464-0464",
"PracticeLocationAddressFaxNumber": "866-636-4063",
"EnumerationDate": "03/11/2013",
"LastUpdateDate": "03/11/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SPRUILL",
"AuthorizedOfficialFirstName": "NICOLE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/SPEECH-LANGUAGE PATHOLOGIST",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.ED CCC-SLP",
"AuthorizedOfficialTelephoneNumber": "704-464-0464",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "252Y00000X",
"TaxonomyName": "Early Intervention Provider Agency",
"LicenseNumber": "7706",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}