1942586912 NPI number — LAURA GAIL MARTIN M.A. CCC-SLP

NPI Number: 1942586912
Health Care Provider/Practitioner: LAURA GAIL MARTIN M.A. CCC-SLP

NPI Number : 1942586912 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1942586912",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARTIN",
    "FirstName": "LAURA",
    "MiddleName": "GAIL",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "M.A. CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GODLASKI",
    "OtherFirstName": "LAURA",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "202 ARLINGTON AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LEXINGTON",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "40508-2708",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "859-559-7183",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "202 ARLINGTON AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LEXINGTON",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40508-2708",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "859-559-7183",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/22/2011",
    "LastUpdateDate": "09/29/2025",
    "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": "142433",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "SLP16621",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}