Provider Demographics
NPI:1528573953
Name:HANDLEY, NATALIE NICOLE (MAT, ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:NICOLE
Last Name:HANDLEY
Suffix:
Gender:F
Credentials:MAT, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 S HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-5036
Mailing Address - Country:US
Mailing Address - Phone:830-990-4550
Mailing Address - Fax:830-990-2802
Practice Address - Street 1:1121 S MILAM ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-5349
Practice Address - Country:US
Practice Address - Phone:830-990-4550
Practice Address - Fax:830-990-2802
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT44292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer