Provider Demographics
NPI:1518264076
Name:HERRICK, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:HERRICK
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 1:130 SUNRISE BLVD.
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713
Mailing Address - Country:US
Mailing Address - Phone:724-887-4254
Mailing Address - Fax:724-626-2785
Practice Address - Street 1:366 E. GRAVES AVE.
Practice Address - Street 2:STE D
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763
Practice Address - Country:US
Practice Address - Phone:407-986-4589
Practice Address - Fax:407-890-6763
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist