Provider Demographics
NPI:1104570829
Name:HARRIS, NATALIE LUCIA-MARIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:LUCIA-MARIE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4236
Mailing Address - Country:US
Mailing Address - Phone:224-391-8929
Mailing Address - Fax:
Practice Address - Street 1:1414 W LOMBARD ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-2148
Practice Address - Country:US
Practice Address - Phone:563-468-2309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker