NPI Code Detail JSON Logo

1891674834 NPI number — MIKAYLA RAE EUBANKS M.A, CCC-SLP

NPI Number: 1891674834
Health Care Provider/Practitioner: MIKAYLA RAE EUBANKS M.A, CCC-SLP

Information about “1891674834” NPI (MIKAYLA RAE EUBANKS M.A, CCC-SLP) exists in 1891674834 in HTML format HTML  |  1891674834 in plain Text format TXT  |  1891674834 in PDF (Portable Document Format) PDF  |  1891674834 in an XML format XML  formats.

NPI Number : 1891674834 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1891674834",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EUBANKS",
    "FirstName": "MIKAYLA",
    "MiddleName": "RAE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.A, CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DEAVENPORT",
    "OtherFirstName": "MIKAYLA",
    "OtherMiddleName": "RAE EUBANKS",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.A CCC-SLP",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "7720 OCONNOR DR APT 3013",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ROUND ROCK",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78681-5577",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "325-315-8753",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3610 WILLIAMS DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GEORGETOWN",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78628-2420",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "512-256-7627",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/02/2025",
    "LastUpdateDate": "09/02/2025",
    "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": "123046",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.