Provider Demographics
NPI:1881103968
Name:MCHALE, NATALIE MARIE (COTA/L)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:MCHALE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MARIE
Other - Last Name:MCHALE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA/L
Mailing Address - Street 1:1617 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32266-4912
Mailing Address - Country:US
Mailing Address - Phone:904-451-0594
Mailing Address - Fax:
Practice Address - Street 1:9141 CYPRESS GREEN DR STE 2
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-2006
Practice Address - Country:US
Practice Address - Phone:904-647-1849
Practice Address - Fax:904-647-2625
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant