{
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"FirstLineMailingAddress": "PO BOX 30755",
"SecondLineMailingAddress": null,
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"MailingAddressPostalCode": "85751-0755",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "520-722-2892",
"MailingAddressFaxNumber": "520-722-2873",
"FirstLinePracticeLocationAddress": "5956 E PIMA ST",
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"EnumerationDate": "03/08/2007",
"LastUpdateDate": "03/24/2008",
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"NPIReactivationDate": null,
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"Gender": null,
"AuthorizedOfficialLastName": "NICHOLSON",
"AuthorizedOfficialFirstName": "ELAINE",
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"AuthorizedOfficialCredential": "PHD",
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"Taxonomies": {
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"TaxonomyName": "Psychologist",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}