Provider Demographics
NPI:1235563750
Name:NACE, NATALIE SUZANNE (BSW)
Entity Type:Individual
Prefix:MISS
First Name:NATALIE
Middle Name:SUZANNE
Last Name:NACE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S MUSTANG RD
Mailing Address - Street 2:3511
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-0306
Mailing Address - Country:US
Mailing Address - Phone:610-751-4131
Mailing Address - Fax:
Practice Address - Street 1:5401 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73179-7602
Practice Address - Country:US
Practice Address - Phone:405-681-2003
Practice Address - Fax:405-681-2013
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor