NPI Code Detail JSON Logo

1639932361 NPI number — KENYA YVONNE DOCK MS

NPI Number: 1639932361
Health Care Provider/Practitioner: KENYA YVONNE DOCK MS

Information about “1639932361” NPI (KENYA YVONNE DOCK MS) exists in 1639932361 in HTML format HTML  |  1639932361 in plain Text format TXT  |  1639932361 in PDF (Portable Document Format) PDF  |  1639932361 in an XML format XML  formats.

NPI Number : 1639932361 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639932361",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DOCK",
    "FirstName": "KENYA",
    "MiddleName": "YVONNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GARRISON",
    "OtherFirstName": "KENYA",
    "OtherMiddleName": "YVONNE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MS",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2626 TEAKWOOD DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HEPHZIBAH",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30815-6059",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "706-294-2614",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2626 TEAKWOOD DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HEPHZIBAH",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30815-6059",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "706-294-2614",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/05/2024",
    "LastUpdateDate": "02/05/2024",
    "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": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "LPC013111",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.