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1962536425 NPI number — GWEN ALYSON HINRICHS M.A., SLP

NPI Number: 1962536425
Health Care Provider/Practitioner: GWEN ALYSON HINRICHS M.A., SLP

Information about “1962536425” NPI (GWEN ALYSON HINRICHS M.A., SLP) exists in 1962536425 in HTML format HTML  |  1962536425 in plain Text format TXT  |  1962536425 in PDF (Portable Document Format) PDF  |  1962536425 in an XML format XML  formats.

NPI Number : 1962536425 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962536425",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HINRICHS",
    "FirstName": "GWEN",
    "MiddleName": "ALYSON",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.A., SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GRIFFIN",
    "OtherFirstName": "GWEN",
    "OtherMiddleName": "ALYSON",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.A., CCC-SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1100 IMPERIAL DR UNIT 108",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SARASOTA",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34236-2453",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "610-909-0111",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "100 IMPERIAL DR",
    "SecondLinePracticeLocationAddress": "UNIT 108",
    "PracticeLocationAddressCityName": "SARASOTA",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34236",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "610-909-0111",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/15/2007",
    "LastUpdateDate": "07/11/2023",
    "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": "SL004320L",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "SA14673",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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