Provider Demographics
NPI:1972295111
Name:YATAK, NAZHA BELAL
Entity Type:Individual
Prefix:
First Name:NAZHA
Middle Name:BELAL
Last Name:YATAK
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 1:2121 N OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-2936
Mailing Address - Country:US
Mailing Address - Phone:954-871-3377
Mailing Address - Fax:
Practice Address - Street 1:2121 N OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-2936
Practice Address - Country:US
Practice Address - Phone:954-871-3377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician