Provider Demographics
NPI:1508117656
Name:MOORE, NATALIE (RMT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RMT, ALD,
Mailing Address - Street 1:PO BOX 40105
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-0002
Mailing Address - Country:US
Mailing Address - Phone:512-655-3570
Mailing Address - Fax:
Practice Address - Street 1:3115 S 1ST ST
Practice Address - Street 2:104
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-8847
Practice Address - Country:US
Practice Address - Phone:512-655-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral