{
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"FirstLineMailingAddress": "850 ENTERPRISE COVE AVE APT 202",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ORANGE CITY",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32763-8370",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "386-801-5276",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "118 1/2 N WOODLAND BLVD",
"SecondLinePracticeLocationAddress": "SUITE 4",
"PracticeLocationAddressCityName": "DELAND",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "386-801-5276",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/09/2008",
"LastUpdateDate": "05/16/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MT2221",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}