Provider Demographics
NPI:1508494261
Name:NATERA, ANALYSSIA
Entity Type:Individual
Prefix:MRS
First Name:ANALYSSIA
Middle Name:
Last Name:NATERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3731 STONEWAY RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-0648
Mailing Address - Country:US
Mailing Address - Phone:575-956-3696
Mailing Address - Fax:
Practice Address - Street 1:3731 STONEWAY RD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012-0648
Practice Address - Country:US
Practice Address - Phone:575-956-3696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician