Provider Demographics
NPI:1265621429
Name:NEAL, NATALIE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:STINIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:20162 SW BIRCH ST STE 350
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-0790
Mailing Address - Country:US
Mailing Address - Phone:714-396-8685
Mailing Address - Fax:949-610-7660
Practice Address - Street 1:20162 SW BIRCH ST STE 350
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0790
Practice Address - Country:US
Practice Address - Phone:714-396-8685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15728235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist