Provider Demographics
NPI:1417739376
Name:TUNNELL, NATALIE CLAIRE (PHD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:CLAIRE
Last Name:TUNNELL
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 1:4111 BROADWAY UNIT 221
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3352
Mailing Address - Country:US
Mailing Address - Phone:806-292-6610
Mailing Address - Fax:
Practice Address - Street 1:4111 BROADWAY UNIT 221
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3352
Practice Address - Country:US
Practice Address - Phone:806-292-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023040347103TH0004X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth