Provider Demographics
NPI:1598299018
Name:HEST, NATALIE MARIE ROBERTS (MT-BC/L)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE ROBERTS
Last Name:HEST
Suffix:
Gender:F
Credentials:MT-BC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 8TH AVE NW APT 106
Mailing Address - Street 2:
Mailing Address - City:DILWORTH
Mailing Address - State:MN
Mailing Address - Zip Code:56529-1641
Mailing Address - Country:US
Mailing Address - Phone:248-563-5612
Mailing Address - Fax:
Practice Address - Street 1:6046 14TH ST S UNIT B
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-7340
Practice Address - Country:US
Practice Address - Phone:248-563-5612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12506225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist