Doctor Name: | NATOSHA PENA |
NPI Number: | 1043596976 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 5056 |
Business Practice Address: | 1112 5th St Gretna, LA - 700536008 |
Business Phone Number: | 5043736026 |
Business Fax Number: | |
Mailing Address: | 2115 Illinois Ave, KENNER |
State: | LA |
Postal Code: | 700625920 |
Phone Number: | 5047178592 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2011 |
NPI Last Update Date: | 10/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 5056 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |