Provider Demographics
NPI:1700494465
Name:WELCH, NATASHA (RBT)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3030 NW EXPRESSWAY
Mailing Address - Street 2:SUITE 200 NUMBER 452
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112
Mailing Address - Country:US
Mailing Address - Phone:405-383-9001
Mailing Address - Fax:844-447-0582
Practice Address - Street 1:3030 NW EXPRESSWAY
Practice Address - Street 2:SUITE 200 NUMBER 452
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112
Practice Address - Country:US
Practice Address - Phone:405-383-9001
Practice Address - Fax:844-447-0582
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20-127577106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician