Provider Demographics
NPI:1295466654
Name:O'CONNOR, NATALIE
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:O'CONNOR
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 1:1010 WAYNE AVE STE 675
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-5676
Mailing Address - Country:US
Mailing Address - Phone:240-292-1719
Mailing Address - Fax:
Practice Address - Street 1:109 MARQUIS DR
Practice Address - Street 2:
Practice Address - City:EIGHTY FOUR
Practice Address - State:PA
Practice Address - Zip Code:15330-2871
Practice Address - Country:US
Practice Address - Phone:304-919-2843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician