Provider Demographics
NPI:1184872020
Name:GRIDER, NATASHA JOY (MSSW)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:JOY
Last Name:GRIDER
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 S ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-2353
Mailing Address - Country:US
Mailing Address - Phone:812-339-1691
Mailing Address - Fax:812-378-8367
Practice Address - Street 1:3008 N BEVCHER DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-0000
Practice Address - Country:US
Practice Address - Phone:812-265-1918
Practice Address - Fax:812-378-8367
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor