Provider Demographics
NPI:1821859992
Name:BOHLER, NATASHA DANIELLE
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:DANIELLE
Last Name:BOHLER
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 1:739 S 10TH ST APT 3H
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07108-3504
Mailing Address - Country:US
Mailing Address - Phone:904-580-7106
Mailing Address - Fax:
Practice Address - Street 1:739 S 10TH ST APT 3H
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07108-3504
Practice Address - Country:US
Practice Address - Phone:904-580-7106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician