Provider Demographics
NPI:1174375604
Name:DEGRIJZE, NATALIE SUHEI
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:SUHEI
Last Name:DEGRIJZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WARDS LN
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-2114
Mailing Address - Country:US
Mailing Address - Phone:631-327-6851
Mailing Address - Fax:
Practice Address - Street 1:17 WARDS LN
Practice Address - Street 2:
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-2114
Practice Address - Country:US
Practice Address - Phone:631-327-6851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP115948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health