Provider Demographics
NPI:1558004630
Name:POGOSTIN, NATALIE ELIZABETH
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ELIZABETH
Last Name:POGOSTIN
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 1:405 NW 45TH TERRACE
Mailing Address - Street 2:APT 101
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442
Mailing Address - Country:US
Mailing Address - Phone:214-336-7880
Mailing Address - Fax:
Practice Address - Street 1:405 NW 45TH TERRACE
Practice Address - Street 2:APT 101
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-3344
Practice Address - Country:US
Practice Address - Phone:214-336-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician