Provider Demographics
NPI:1609005420
Name:DIDI, NATASCHA LEAH (CLINICAL PSYCH)
Entity Type:Individual
Prefix:DR
First Name:NATASCHA
Middle Name:LEAH
Last Name:DIDI
Suffix:
Gender:F
Credentials:CLINICAL PSYCH
Other - Prefix:DR
Other - First Name:NATASCHA
Other - Middle Name:LEAH
Other - Last Name:DIDI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3960
Mailing Address - Country:US
Mailing Address - Phone:508-828-9116
Mailing Address - Fax:
Practice Address - Street 1:1 WASHINGTON ST
Practice Address - Street 2:MILL RIVER PROFESSIONAL CENTER
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3960
Practice Address - Country:US
Practice Address - Phone:508-823-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
283Q00000X, 101Y00000X
MA19311781103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor