Provider Demographics
NPI:1407625742
Name:NAU, ELIKHA (CTRS)
Entity Type:Individual
Prefix:
First Name:ELIKHA
Middle Name:
Last Name:NAU
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 DEERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30116-5010
Mailing Address - Country:US
Mailing Address - Phone:352-871-2032
Mailing Address - Fax:
Practice Address - Street 1:130 DEERFIELD LN
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30116-5010
Practice Address - Country:US
Practice Address - Phone:352-871-2032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist