MEDICARE: NATALIE RAFIEL BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	9995	TX

General Provider Information

NPI Number	:	1366259061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE RAFIEL BCBA

Provider Business Mailing Address
First Line	:	4927 LAKE RIDGE PKWY
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-3087
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4927 LAKE RIDGE PKWY
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-3087
Country	:	US
Telephone Number	:	855-782-7822
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	03/20/2026

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