Healthcare Provider Details

I. General information

NPI: 1881162998
Provider Name (Legal Business Name): NATESE DOCKERY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 E WILSON BRIDGE RD STE 203
WORTHINGTON OH
43085-2382
US

IV. Provider business mailing address

9000 BURMA RD STE 109
PALM BEACH GARDENS FL
33403-1606
US

V. Phone/Fax

Practice location:
  • Phone: 614-354-4822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2103217
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: