Natacha Tatiana Bryan, M.ED
Individual provider Active NPI Psychologist · Page, AZ
NPI 1003935396 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003935396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 3324983 (AZ)
- Practice address
- 101 El Mirage
Page, AZ 86040-1927 - Phone
- (928) 608-4312
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3324983 | AZ | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3324983 | AZ | Yes |
Addresses
Primary practice location
101 El Mirage
Page, AZ 86040-1927
Mailing address
PO Box 1927
Page, AZ 86040-1927
Phone (928) 608-4312
Other providers in Page, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.