Provider Demographics
NPI:1528531456
Name:PRINCE, NATASHA E
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:E
Last Name:PRINCE
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 1:9667 HAGEL CIR
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4316
Mailing Address - Country:US
Mailing Address - Phone:571-882-4978
Mailing Address - Fax:
Practice Address - Street 1:3231 SUPERIOR LN STE A6
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1939
Practice Address - Country:US
Practice Address - Phone:301-464-5129
Practice Address - Fax:240-718-1700
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist