{
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"EIN": null,
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"FirstLineMailingAddress": "4111 ORMOND RD",
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"MailingAddressCityName": "LOUISVILLE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40207-2166",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "502-893-9448",
"MailingAddressFaxNumber": "502-515-6888",
"FirstLinePracticeLocationAddress": "4111 ORMOND RD",
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"PracticeLocationAddressCityName": "LOUISVILLE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "502-893-9448",
"PracticeLocationAddressFaxNumber": "502-515-6888",
"EnumerationDate": "05/07/2007",
"LastUpdateDate": "07/08/2007",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "KY-R0934",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}