{
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"FirstLineMailingAddress": "9263 S REDWOOD RD",
"SecondLineMailingAddress": "BUILDING 8 SUITE B",
"MailingAddressCityName": "WEST JORDAN",
"MailingAddressStateName": "UT",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-566-0749",
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"FirstLinePracticeLocationAddress": "9263 S REDWOOD RD",
"SecondLinePracticeLocationAddress": "BUILDING 8 SUITE B",
"PracticeLocationAddressCityName": "WEST JORDAN",
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"PracticeLocationAddressTelephoneNumber": "801-566-0749",
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"EnumerationDate": "03/25/2014",
"LastUpdateDate": "03/25/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OWEN",
"AuthorizedOfficialFirstName": "BETTY",
"AuthorizedOfficialMiddleName": "JO",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": "LCWS",
"AuthorizedOfficialTelephoneNumber": "801-566-0749",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Professional Counselor",
"LicenseNumber": "20725",
"LicenseNumberStateCode": "UT",
"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."
}
}
}
}