Provider Demographics
NPI:1619224961
Name:DUKES, NATALIE SHARONETTE (MED, RMHI)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:SHARONETTE
Last Name:DUKES
Suffix:
Gender:F
Credentials:MED, RMHI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:CHATTAHOOCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:32324-2330
Mailing Address - Country:US
Mailing Address - Phone:850-294-1399
Mailing Address - Fax:
Practice Address - Street 1:19 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:CHATTAHOOCHEE
Practice Address - State:FL
Practice Address - Zip Code:32324-2330
Practice Address - Country:US
Practice Address - Phone:850-294-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH8010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health