Provider Demographics
NPI:1396299426
Name:RONDEAU, NATASHA VICTORIA
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:VICTORIA
Last Name:RONDEAU
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 1:27173 GATEWAY DR W
Mailing Address - Street 2:APT 301
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4983
Mailing Address - Country:US
Mailing Address - Phone:517-366-8240
Mailing Address - Fax:
Practice Address - Street 1:27173 GATEWAY DR W
Practice Address - Street 2:APT 301
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4983
Practice Address - Country:US
Practice Address - Phone:517-366-8240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other