Provider Demographics
NPI:1043909849
Name:TSASA, NATALIE GHISLAINE
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:GHISLAINE
Last Name:TSASA
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 1:2821 W HORIZON RIDGE PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4429
Mailing Address - Country:US
Mailing Address - Phone:702-817-6991
Mailing Address - Fax:
Practice Address - Street 1:2821 W HORIZON RIDGE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4429
Practice Address - Country:US
Practice Address - Phone:702-840-1182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician