Provider Demographics
NPI:1033954219
Name:GUERRERO TAVAREZ, NATALIA ARLETTE
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:ARLETTE
Last Name:GUERRERO TAVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NATALIA
Other - Middle Name:ARLETTE
Other - Last Name:TAVAREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10 MADRID SQ APT 9
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:44 DIAUTO DR
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4536
Practice Address - Country:US
Practice Address - Phone:774-274-8334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
MA4K60171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator