Provider Demographics
NPI:1174004493
Name:DUKE, NATALIE CHRISTINE (COTA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:CHRISTINE
Last Name:DUKE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 NATHAN DR
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-7657
Mailing Address - Country:US
Mailing Address - Phone:501-337-6634
Mailing Address - Fax:
Practice Address - Street 1:1511 MARLANDWOOD RD
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3338
Practice Address - Country:US
Practice Address - Phone:254-899-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14299224Z00000X
TX214882224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant