| Doctor Name: | NATASHA TOM |
| NPI Number: | 1003246505 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 127 N 3rd Ave Durant, OK - 747014700 |
| Business Phone Number: | 5809313008 |
| Business Fax Number: | 5809318022 |
| Mailing Address: | Po Box 48, MEAD |
| State: | OK |
| Postal Code: | 734490048 |
| Phone Number: | 5807459610 |
| Fax Number: | 5807459891 |
| NPI Enumeration Date: | 11/19/2013 |
| NPI Last Update Date: | 11/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |