Provider Demographics
NPI:1144092156
Name:PRIEST, NATALIE (COTA/ L)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:PRIEST
Suffix:
Gender:F
Credentials:COTA/ L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17769 W CROCUS DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-7527
Mailing Address - Country:US
Mailing Address - Phone:928-300-8664
Mailing Address - Fax:
Practice Address - Street 1:17777 W WESTAR DR
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-5362
Practice Address - Country:US
Practice Address - Phone:928-300-8664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTA-047285224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant