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General NPI Number Information
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NPI Number | 1609294610
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Entity Type | Individual
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Provider Name | NATASHA NICOLE PERRY M.A.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 03/25/2023
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Provider Practice Location Address
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Address Line | 6230 LAPIS LN
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City | CRESTVIEW
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State | FL
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Zip | 32539-5425
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Country | US
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Telephone | 850-333-3103
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Fax |
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Provider Business Mailing Address
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Address Line | 6230 LAPIS LN
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City | CRESTVIEW
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State | FL
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Zip | 32539-5425
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Country | US
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Telephone | 850-333-3103
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | FL
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