Provider Demographics
NPI:1881351401
Name:THOMAS, NATASCHA MICHELE
Entity type:Individual
Prefix:
First Name:NATASCHA
Middle Name:MICHELE
Last Name:THOMAS
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 1:115 PROSPERITY AVE SE APT A
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-4168
Mailing Address - Country:US
Mailing Address - Phone:571-528-6055
Mailing Address - Fax:
Practice Address - Street 1:115 PROSPERITY AVE SE APT A
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-4168
Practice Address - Country:US
Practice Address - Phone:571-528-6055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst