Provider Demographics
NPI:1194480970
Name:CUEVA, NATASHA R
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:R
Last Name:CUEVA
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 1:6470 TAFT ST APT 130
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-4143
Mailing Address - Country:US
Mailing Address - Phone:954-558-4325
Mailing Address - Fax:
Practice Address - Street 1:6470 TAFT ST APT 130
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-4143
Practice Address - Country:US
Practice Address - Phone:954-558-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician