Provider Demographics
NPI:1013738814
Name:COLIN, NATHALIE A (PSYD)
Entity type:Individual
Prefix:DR
First Name:NATHALIE
Middle Name:A
Last Name:COLIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 E ROCCO RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-1754
Mailing Address - Country:US
Mailing Address - Phone:435-314-7578
Mailing Address - Fax:
Practice Address - Street 1:416 E ROCCO RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-1754
Practice Address - Country:US
Practice Address - Phone:435-314-7578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12198660-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist