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1639796782 NPI number — MADELYN STOTT

NPI Number: 1639796782
Health Care Provider/Practitioner: MADELYN STOTT

Information about “1639796782” NPI (MADELYN STOTT) exists in 1639796782 in HTML format HTML  |  1639796782 in plain Text format TXT  |  1639796782 in PDF (Portable Document Format) PDF  |  1639796782 in an XML format XML  formats.

NPI Number : 1639796782 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639796782",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STOTT",
    "FirstName": "MADELYN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6416 NW 5TH WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FT LAUDERDALE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33309-6112",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "888-754-0398",
    "MailingAddressFaxNumber": "954-982-6491",
    "FirstLinePracticeLocationAddress": "12503 E EUCLID DR STE 55",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CENTENNIAL",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80111-6466",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "888-754-0398",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/05/2020",
    "LastUpdateDate": "01/14/2022",
    "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": "106S00000X",
          "TaxonomyName": "Behavior Technician",
          "LicenseNumber": "RBT-19-80184",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": "1-21-56470",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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