Provider Demographics
NPI:1154030294
Name:NATALIZIO, AMANDA JANE (PHD, HCLD(ABB))
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JANE
Last Name:NATALIZIO
Suffix:
Gender:F
Credentials:PHD, HCLD(ABB)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31307 RIBBONWOOD PARK LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3069
Mailing Address - Country:US
Mailing Address - Phone:330-347-4515
Mailing Address - Fax:
Practice Address - Street 1:31307 RIBBONWOOD PARK LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-3069
Practice Address - Country:US
Practice Address - Phone:330-347-4515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
20182409246ZG1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZG1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGeneticist, Medical (PhD)