{
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"OrgName": "KINER SPEECH SERVICES",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "2887 PARK PLACE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAND PRAIRIE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75052-8520",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-652-1895",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2887 PARK PLACE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRAND PRAIRIE",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-652-1895",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/05/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KINER",
"AuthorizedOfficialFirstName": "TONGULA",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "OWNER/CEO",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.M.,CCC-SLP",
"AuthorizedOfficialTelephoneNumber": "817-652-1895",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "17240",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}