{"npi":"1194248773","type":"NPI-1","status":"active","name":{"display":"Charmin Rose Gentry Bcba","other":[],"first":"CHARMIN ROSE","last":"GENTRY","credential":"BCBA"},"specialty":{"primary_taxonomy":"103K00000X","primary_taxonomy_description":"Behavior Analyst","slug":"behavior-analyst","schema_org_specialty":null,"all":[{"code":"106E00000X","description":"Assistant Behavior Analyst","primary":false,"state":null,"license":null},{"code":"103K00000X","description":"Behavior Analyst","primary":true,"state":null,"license":"1-22-62808"}]},"addresses":[{"purpose":"LOCATION","street_1":"2820 CAMINO DEL RIO S STE 100","city":"SAN DIEGO","state":"CA","postal_code":"921083822","country_code":"US","phone":"8004348923","fax":"6159059200"},{"purpose":"MAILING","street_1":"2820 CAMINO DEL RIO S STE 100","city":"SAN DIEGO","state":"CA","postal_code":"921083822","country_code":"US","phone":"8004348923","fax":"6159059200"}],"license":{"state":null,"number":"1-22-62808"},"identifiers":[{"type_code":"01","label":"Other","value":"0-17-7794","state":null,"issuer":"BEHAVIOR ANALYST CERTIFICATION BOARD, INC. (BACB)"},{"type_code":"01","label":"Other","value":"1-22-62808","state":"CA","issuer":"BEHAVIOR ANALYST CERTIFICATION BOARD, INC. (BACB)"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2017-07-25","last_updated":"2023-07-21","_meta":{"source":"NPPES","snapshot_date":"2023-07-21","doc_url":"https://findmynpi.com/api"}}