Provider Demographics
NPI:1326251497
Name:LASKO, NATASHA B (PHD)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:B
Last Name:LASKO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 SMYTH RD
Mailing Address - Street 2:VA RESEARCH SERVICE (151)
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-7004
Mailing Address - Country:US
Mailing Address - Phone:603-624-4366
Mailing Address - Fax:603-629-3265
Practice Address - Street 1:718 SMYTH RD
Practice Address - Street 2:VA RESEARCH SERVICE (151)
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-7004
Practice Address - Country:US
Practice Address - Phone:603-624-4366
Practice Address - Fax:603-629-3265
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4377101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health