{
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"FirstLineMailingAddress": "2060 NORTHBROOK BLVD, SUITE 103",
"SecondLineMailingAddress": "CAROLINA CHILDREN'S THERAPY LLC",
"MailingAddressCityName": "N. CHARLESTON",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29406-9811",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-572-2450",
"MailingAddressFaxNumber": "843-572-2451",
"FirstLinePracticeLocationAddress": "2060 NORTHBROOK BLVD, SUITE 103",
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"PracticeLocationAddressCityName": "N CHARLESTON",
"PracticeLocationAddressStateName": "SC",
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"PracticeLocationAddressTelephoneNumber": "843-572-2450",
"PracticeLocationAddressFaxNumber": "843-572-2451",
"EnumerationDate": "09/10/2010",
"LastUpdateDate": "09/10/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "SCHROM",
"AuthorizedOfficialFirstName": "NESSIE",
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"AuthorizedOfficialTitle": "DIRECTOR",
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"AuthorizedOfficialCredential": "OTR/L, BCP",
"AuthorizedOfficialTelephoneNumber": "843-572-2450",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Occupational Therapist",
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"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}