Provider Demographics
NPI:1043939853
Name:LASSALLE PINEIRO, NATASHA ALEXANDRA (THL)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:ALEXANDRA
Last Name:LASSALLE PINEIRO
Suffix:
Gender:F
Credentials:THL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 20599
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-8165
Mailing Address - Country:US
Mailing Address - Phone:787-452-7157
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM 59 HM5 SECTOR TIBURON
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-372-3736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR72052355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant