Provider Demographics
NPI:1679265367
Name:COLE, NATALIE KAY (SLPA)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:KAY
Last Name:COLE
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13171 W SAGUARO LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-5239
Mailing Address - Country:US
Mailing Address - Phone:928-856-0378
Mailing Address - Fax:
Practice Address - Street 1:3150 N ARIZONA AVE STE 105
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7170
Practice Address - Country:US
Practice Address - Phone:480-347-8938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA143552355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ458161Medicaid