Provider Demographics
NPI:1114380979
Name:FOLSE, NATASHIA
Entity Type:Individual
Prefix:
First Name:NATASHIA
Middle Name:
Last Name:FOLSE
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 1:3365 MARKET ST.
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:LA
Mailing Address - Zip Code:70748
Mailing Address - Country:US
Mailing Address - Phone:225-223-1175
Mailing Address - Fax:
Practice Address - Street 1:3365 MARKET ST.
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:LA
Practice Address - Zip Code:70748
Practice Address - Country:US
Practice Address - Phone:225-223-1175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor