Provider Demographics
NPI:1003606096
Name:GLADE, NATALIE CLAIRE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:CLAIRE
Last Name:GLADE
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 1:30 W CARTER DR APT 15-107
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7708
Mailing Address - Country:US
Mailing Address - Phone:909-836-4147
Mailing Address - Fax:
Practice Address - Street 1:665 N GILBERT RD STE 152
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-3395
Practice Address - Country:US
Practice Address - Phone:602-726-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician