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1871930453 NPI number — GAYLE MARIE OSTERBERG LLP

NPI Number: 1871930453
Health Care Provider/Practitioner: GAYLE MARIE OSTERBERG LLP

Information about “1871930453” NPI (GAYLE MARIE OSTERBERG LLP) exists in 1871930453 in HTML format HTML  |  1871930453 in plain Text format TXT  |  1871930453 in PDF (Portable Document Format) PDF  |  1871930453 in an XML format XML  formats.

NPI Number : 1871930453 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871930453",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OSTERBERG",
    "FirstName": "GAYLE",
    "MiddleName": "MARIE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DOPKE",
    "OtherFirstName": "GAYLE",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "TLLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1402 S SAGINAW ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FLINT",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48503-3705",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "810-287-8653",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1402 S SAGINAW ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLINT",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48503-3705",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "810-287-8653",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/23/2013",
    "LastUpdateDate": "03/22/2024",
    "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": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "6301015150",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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