{
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"FirstLineMailingAddress": "629 SW 89TH",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OKLAHOMA CITY",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73139-9337",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "405-703-8424",
"MailingAddressFaxNumber": "405-703-8434",
"FirstLinePracticeLocationAddress": "1414 SW 89TH ST",
"SecondLinePracticeLocationAddress": "STE A",
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"PracticeLocationAddressStateName": "OK",
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"PracticeLocationAddressFaxNumber": "405-703-8434",
"EnumerationDate": "07/30/2019",
"LastUpdateDate": "07/30/2019",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HENDRIX",
"AuthorizedOfficialFirstName": "SARAH",
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"AuthorizedOfficialCredential": "OTR",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Occupational Therapist",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}