Provider Demographics
NPI:1386097061
Name:REYNAGA, NATALIA
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:REYNAGA
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 1:3786 MADISON LN
Mailing Address - Street 2:APT. A
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3680
Mailing Address - Country:US
Mailing Address - Phone:619-754-3237
Mailing Address - Fax:
Practice Address - Street 1:3786 MADISON LN
Practice Address - Street 2:APT. A
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3680
Practice Address - Country:US
Practice Address - Phone:619-754-3237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer