Individual
NATASHA SOUTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 CAPITOL WAY, BISMARCK, ND 58501
(701) 204-7870
(701) 491-7505
Mailing address
1615 CAPITOL WAY, BISMARCK, ND 58501
(701) 204-7870
(701) 491-7505
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-24-353554
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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