Provider Demographics
NPI:1336322551
Name:NATALINO, JORDAN A
Entity Type:Individual
Prefix:MISS
First Name:JORDAN
Middle Name:A
Last Name:NATALINO
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 1:23 1/2 BOWERS ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3904
Mailing Address - Country:US
Mailing Address - Phone:978-972-5995
Mailing Address - Fax:
Practice Address - Street 1:130 PARKER ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1556
Practice Address - Country:US
Practice Address - Phone:978-475-2938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist