Provider Demographics
NPI:1497291017
Name:SCAREBROOK, NATASHA (LMT, CLT)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:SCAREBROOK
Suffix:
Gender:F
Credentials:LMT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 COBB PKWY NW STE 708
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-9531
Mailing Address - Country:US
Mailing Address - Phone:404-396-5956
Mailing Address - Fax:
Practice Address - Street 1:3950 COBB PKWY NW STE 708
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-9531
Practice Address - Country:US
Practice Address - Phone:404-396-5956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-07
Last Update Date:2017-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT001501225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist