Provider Demographics
NPI:1922370873
Name:LAZARO, NATASHA NICHOLE
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:NICHOLE
Last Name:LAZARO
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 1:180 W HUFFAKER LN STE 302
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2091
Mailing Address - Country:US
Mailing Address - Phone:759-973-7737
Mailing Address - Fax:
Practice Address - Street 1:180 W HUFFAKER LN STE 302
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2091
Practice Address - Country:US
Practice Address - Phone:775-997-3773
Practice Address - Fax:775-322-4460
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty