Provider Demographics
NPI:1104651389
Name:CHOUMAN, NATALIE AYA
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:AYA
Last Name:CHOUMAN
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 1:93 PARK ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3936
Mailing Address - Country:US
Mailing Address - Phone:508-661-9923
Mailing Address - Fax:
Practice Address - Street 1:50 TOWER OFFICE PARK
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-2113
Practice Address - Country:US
Practice Address - Phone:339-666-4705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health