Provider Demographics
NPI:1457503427
Name:STAPLETON, NATASHA SALENA (MA,CCC-SLP/TSHH)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:SALENA
Last Name:STAPLETON
Suffix:
Gender:F
Credentials:MA,CCC-SLP/TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20306 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-1339
Mailing Address - Country:US
Mailing Address - Phone:718-464-5544
Mailing Address - Fax:
Practice Address - Street 1:20306 109TH AVE
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-1339
Practice Address - Country:US
Practice Address - Phone:718-464-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014126-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist