Healthcare Provider Details

I. General information

NPI: 1083539548
Provider Name (Legal Business Name): NATALIE JANELLE STOTTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATALIE JANELLE SHIRER

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 E STROOP RD
KETTERING OH
45429-4925
US

IV. Provider business mailing address

3095 KETTERING BLVD
MORAINE OH
45439-1983
US

V. Phone/Fax

Practice location:
  • Phone: 937-293-8300
  • Fax:
Mailing address:
  • Phone: 937-534-1352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2614410
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: