Provider Demographics
NPI:1922589928
Name:RAPER, NATHALIE
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:
Last Name:RAPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NATHALIE
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:7540 ARBOR HILL DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-2414
Mailing Address - Country:US
Mailing Address - Phone:760-214-7876
Mailing Address - Fax:
Practice Address - Street 1:2415 COIT RD STE B
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3758
Practice Address - Country:US
Practice Address - Phone:972-596-7229
Practice Address - Fax:972-596-7410
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73882101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty