Provider Demographics
NPI:1902567126
Name:MCINTOSH, NATASHA LYNN (CIT)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:LYNN
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:LYNN
Other - Last Name:UMFRESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA, MHPP
Mailing Address - Street 1:7255 MEESHOW DR STE A
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-5269
Mailing Address - Country:US
Mailing Address - Phone:479-306-4480
Mailing Address - Fax:479-306-4488
Practice Address - Street 1:7255 MEESHOW DR STE A
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-5269
Practice Address - Country:US
Practice Address - Phone:479-306-4480
Practice Address - Fax:479-306-4488
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)