Healthcare Provider Details

I. General information

NPI: 1427256056
Provider Name (Legal Business Name): NATALIE ELIZABETH MASON OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

752 OLD MILL RD
CHAPEL HILL NC
27514-3927
US

IV. Provider business mailing address

752 OLD MILL RD
CHAPEL HILL NC
27514-3927
US

V. Phone/Fax

Practice location:
  • Phone: 919-960-9925
  • Fax:
Mailing address:
  • Phone: 919-960-9925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number3803
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier7301588
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: