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General NPI Number Information
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NPI Number | 1811814452
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Entity Type | Individual
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Provider Name | NATALIA KHUDOKONENKO LAC
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Gender | Female
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Dates
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Enumeration Date | 07/03/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 1821 N TREKELL RD STE 5
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City | CASA GRANDE
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State | AZ
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Zip | 85122-1705
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Country | US
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Telephone | 623-243-2774
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Fax |
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Provider Business Mailing Address
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Address Line | 1270 E LAUREL CT
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City | CASA GRANDE
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State | AZ
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Zip | 85122-2924
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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-24165
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License Number State | AZ
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