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NPI Code Detail

MEDICARE: NATALIE POINDEXTER

MEDICARE: NATALIE POINDEXTER
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
1106S00000XBehavior TechnicianRBT-15-07545

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT-15-07545OTHERBEHAVIOR ANALYST CERTIFICATION

General Provider Information

NPI Number : 1821504887
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE POINDEXTER
Provider Business Mailing Address
First Line : 4225 PORTSMOUTH BLVD STE B
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23321-2154
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4225 PORTSMOUTH BLVD STE B
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23321-2154
Country : US
Telephone Number : 757-292-4774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2017
Last Update Date : 12/28/2017

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Directions to “ NATALIE POINDEXTER ” Practice Location

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