Provider Demographics
NPI:1376057331
Name:PRICE, NATIA DANIELLE
Entity Type:Individual
Prefix:
First Name:NATIA
Middle Name:DANIELLE
Last Name:PRICE
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 1:110 NATHANIEL DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7614
Mailing Address - Country:US
Mailing Address - Phone:318-237-0729
Mailing Address - Fax:
Practice Address - Street 1:801 N 31ST ST STE 1
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3959
Practice Address - Country:US
Practice Address - Phone:318-737-7794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health