{
"Npi": {
"NPI": "1902910607",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LIGUORI",
"FirstName": "LAURA",
"MiddleName": "CHARLENE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PH.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2600 N MAYFAIR RD",
"SecondLineMailingAddress": "SUITE 305",
"MailingAddressCityName": "WAUWATOSA",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53226",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "414-257-0233",
"MailingAddressFaxNumber": "414-257-3588",
"FirstLinePracticeLocationAddress": "250 N SUNNY SLOPE RD",
"SecondLinePracticeLocationAddress": "SUITE 290",
"PracticeLocationAddressCityName": "BROOKFIELD",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53005-4809",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "262-754-9460",
"PracticeLocationAddressFaxNumber": "262-754-9468",
"EnumerationDate": "08/18/2006",
"LastUpdateDate": "04/11/2011",
"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": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "2461-057",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}