Provider Demographics
NPI:1891127809
Name:HARPER, NATISHA (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:NATISHA
Middle Name:
Last Name:HARPER
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:PO BOX 2105
Mailing Address - Street 2:
Mailing Address - City:EATONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32751-1999
Mailing Address - Country:US
Mailing Address - Phone:386-846-8582
Mailing Address - Fax:855-395-0809
Practice Address - Street 1:414 EATON ST
Practice Address - Street 2:
Practice Address - City:EATONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32751-6829
Practice Address - Country:US
Practice Address - Phone:386-846-8582
Practice Address - Fax:855-395-0809
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11416980103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst