Provider Demographics
NPI:1063645638
Name:LAWSON-JOHNSON, NATALIE LORRAINE (LMT, HMLT)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:LORRAINE
Last Name:LAWSON-JOHNSON
Suffix:
Gender:F
Credentials:LMT, HMLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 TROUTMAN BLVD NE
Mailing Address - Street 2:UNIT 206
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-4727
Mailing Address - Country:US
Mailing Address - Phone:321-848-8103
Mailing Address - Fax:
Practice Address - Street 1:1900 S HARBOR CITY BLVD
Practice Address - Street 2:SUITE 117
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-4749
Practice Address - Country:US
Practice Address - Phone:321-848-8103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 54824225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist