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1770465122 NPI number — ELIZABETH JOY MARJORAM RBT, CPR

NPI Number: 1770465122
Health Care Provider/Practitioner: ELIZABETH JOY MARJORAM RBT, CPR

Information about “1770465122” NPI (ELIZABETH JOY MARJORAM RBT, CPR) exists in 1770465122 in HTML format HTML  |  1770465122 in plain Text format TXT  |  1770465122 in PDF (Portable Document Format) PDF  |  1770465122 in an XML format XML  formats.

NPI Number : 1770465122 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1770465122",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARJORAM",
    "FirstName": "ELIZABETH",
    "MiddleName": "JOY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RBT, CPR",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LESTER",
    "OtherFirstName": "ELIZABETH",
    "OtherMiddleName": "JOY",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "419 S STONE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WEST SUFFIELD",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06093-3220",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "931-316-5406",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "114 MAIN ST STE G",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EAST HARTFORD",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06118-3211",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "888-754-0398",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/24/2025",
    "LastUpdateDate": "07/24/2025",
    "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": "BACB1241584",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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