Provider Demographics
NPI:1275297731
Name:COLEBANK, NATALIE (BCBA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:COLEBANK
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 OLD HAYMAKER RD STE 209
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1684
Mailing Address - Country:US
Mailing Address - Phone:724-850-8118
Mailing Address - Fax:
Practice Address - Street 1:8 OLIVER ROAD
Practice Address - Street 2:OLIVER SQUARE PLAZA SUITE 116
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401
Practice Address - Country:US
Practice Address - Phone:724-438-3011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABH002505OtherBEHAVIORAL SPECIALIST
1-21-53936OtherBOARD CERTIFIED BEHAVIOR ANALYST