Provider Demographics
NPI:1659784023
Name:CORZINE, NATALIE (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:CORZINE
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13522 COLISEUM DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3005
Mailing Address - Country:US
Mailing Address - Phone:314-766-1219
Mailing Address - Fax:636-778-0523
Practice Address - Street 1:17300 N OUTER 40 RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1364
Practice Address - Country:US
Practice Address - Phone:636-778-9212
Practice Address - Fax:636-778-0523
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014015726103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst