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General NPI Number Information
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NPI Number | 1801379318
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Entity Type | Individual
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Provider Name | NATITIA PAUGH LAC., LMBT
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Gender | Female
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Dates
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Enumeration Date | 09/11/2018
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Last Update Date | 09/11/2018
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Provider Practice Location Address
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Address Line | 1140 SAM NEWELL RD STE B1
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City | MATTHEWS
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State | NC
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Zip | 28105-5065
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Country | US
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Telephone | 704-309-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 6305 DRYE HILL RD
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City | STANFIELD
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State | NC
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Zip | 28163-5500
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Country | US
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Telephone | 704-309-4000
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 03388
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 1011
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License Number State | NC
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