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General NPI Number Information
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NPI Number | 1427606904
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Entity Type | Individual
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Provider Name | NATALIE STAPLES MA, LAC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 3651 E BASELINE RD STE E-120
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City | GILBERT
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State | AZ
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Zip | 85234-2689
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Country | US
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Telephone | 602-503-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 S MCKEMY ST
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City | TEMPE
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State | AZ
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Zip | 85283-3549
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LAC-18317
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LAC-18317
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License Number State | AZ
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