Provider Demographics
NPI:1972006161
Name:YATES, NATALIE GAIL (BCBA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:GAIL
Last Name:YATES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 GALLIMORE DAIRY RD STE B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-9544
Mailing Address - Country:US
Mailing Address - Phone:317-769-2220
Mailing Address - Fax:904-538-0714
Practice Address - Street 1:420 GALLIMORE DAIRY RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9524
Practice Address - Country:US
Practice Address - Phone:704-770-8645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-21-47300103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst