Healthcare Provider Details

I. General information

NPI: 1326726928
Provider Name (Legal Business Name): NATALIA CULBERTSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 01/11/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33061 N 60TH ST
SCOTTSDALE AZ
85266
US

IV. Provider business mailing address

2050 W UNIVERSITY AVE
FLAGSTAFF AZ
86001-2808
US

V. Phone/Fax

Practice location:
  • Phone: 480-575-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA14547
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: