{
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"OtherCredential": "LMFT",
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"MailingAddressCityName": "MCDONOUGH",
"MailingAddressStateName": "GA",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "5534 OLD NATIONAL HIGHWAY",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "COLLEGE PARK",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "470-765-8550",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/11/2022",
"LastUpdateDate": "07/17/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MFT001929",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}