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1821223132 NPI number — KEISIA NANETTE GALMON CCC-SLP

NPI Number: 1821223132
Health Care Provider/Practitioner: KEISIA NANETTE GALMON CCC-SLP

Information about “1821223132” NPI (KEISIA NANETTE GALMON CCC-SLP) exists in 1821223132 in HTML format HTML  |  1821223132 in plain Text format TXT  |  1821223132 in PDF (Portable Document Format) PDF  |  1821223132 in an XML format XML  formats.

NPI Number : 1821223132 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1821223132",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GALMON",
    "FirstName": "KEISIA",
    "MiddleName": "NANETTE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GALMON",
    "OtherFirstName": "KEISIA",
    "OtherMiddleName": "NANETTE",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "CCC-SLP",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "2656 SOUTH LOOP WEST",
    "SecondLineMailingAddress": "170",
    "MailingAddressCityName": "HOUSTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77054-2673",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "404-668-0170",
    "MailingAddressFaxNumber": "800-956-9786",
    "FirstLinePracticeLocationAddress": "2656 S LOOP W STE 440",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77054-2697",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "281-972-0442",
    "PracticeLocationAddressFaxNumber": "800-956-9786",
    "EnumerationDate": "05/16/2009",
    "LastUpdateDate": "03/29/2019",
    "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": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "SLP006065",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "106563",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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