Provider Demographics
NPI:1285004648
Name:FOCKLER, NATALIE C (BA, MS)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:C
Last Name:FOCKLER
Suffix:
Gender:F
Credentials:BA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NORTH 3RD STREET
Mailing Address - Street 2:CLAYMONT CITY SCHOOLS
Mailing Address - City:DENNISON
Mailing Address - State:OH
Mailing Address - Zip Code:44621
Mailing Address - Country:US
Mailing Address - Phone:740-922-4641
Mailing Address - Fax:
Practice Address - Street 1:215 N 3RD ST
Practice Address - Street 2:
Practice Address - City:DENNISON
Practice Address - State:OH
Practice Address - Zip Code:44621-1237
Practice Address - Country:US
Practice Address - Phone:740-922-4641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist