Provider Demographics
NPI:1497294839
Name:DICK, NATALIE (MS)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:DICK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:KEN
Other - Last Name:GIFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1105 OAK CLUSTER DR
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-6079
Mailing Address - Country:US
Mailing Address - Phone:865-429-0557
Mailing Address - Fax:
Practice Address - Street 1:1105 OAK CLUSTER DR
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-6079
Practice Address - Country:US
Practice Address - Phone:865-429-0557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)