Provider Demographics
NPI:1992257596
Name:ADOLPHE, NATACHA
Entity type:Individual
Prefix:
First Name:NATACHA
Middle Name:
Last Name:ADOLPHE
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 1:10513 LAXTON ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4433
Mailing Address - Country:US
Mailing Address - Phone:321-315-3476
Mailing Address - Fax:407-286-6607
Practice Address - Street 1:10513 LAXTON ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-4433
Practice Address - Country:US
Practice Address - Phone:321-315-3476
Practice Address - Fax:407-286-6607
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-29
Last Update Date:2016-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician