Provider Demographics
NPI:1215284567
Name:NATER, GINA MARIE (MSW)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:NATER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3270 SUNTREE BLVD
Mailing Address - Street 2:101
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7530
Mailing Address - Country:US
Mailing Address - Phone:321-610-7949
Mailing Address - Fax:321-610-7947
Practice Address - Street 1:3270 SUNTREE BLVD
Practice Address - Street 2:101
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7530
Practice Address - Country:US
Practice Address - Phone:321-610-7949
Practice Address - Fax:321-610-7947
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health