Provider Demographics
NPI:1558034660
Name:VROUBLEVSKAIA, NATALLIA
Entity Type:Individual
Prefix:
First Name:NATALLIA
Middle Name:
Last Name:VROUBLEVSKAIA
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 1:2241 PLUMB 1ST ST APT 2L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5754
Mailing Address - Country:US
Mailing Address - Phone:347-845-3507
Mailing Address - Fax:
Practice Address - Street 1:2241 PLUMB 1ST ST APT 2L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5754
Practice Address - Country:US
Practice Address - Phone:347-845-3407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1515712211103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst