Provider Demographics
NPI:1760261390
Name:GARY, NATALIA SHAREE
Entity Type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:SHAREE
Last Name:GARY
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 1:38160 LOWELL DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1134
Mailing Address - Country:US
Mailing Address - Phone:586-303-6553
Mailing Address - Fax:
Practice Address - Street 1:38160 LOWELL DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1134
Practice Address - Country:US
Practice Address - Phone:586-303-6553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI803060062251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health