Basic Information
Provider Information
NPI: 1164941498
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOVILA
FirstName: NATALIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BCBA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6973 UNIVERSITY BOULEVARD
Address2:  
City: WINTER PARK
State: FL
PostalCode: 327926710
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 57 REGIONAL DR STE 7
Address2:  
City: CONCORD
State: NH
PostalCode: 033018518
CountryCode: US
TelephoneNumber: 6032247630
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/19/2017
LastUpdateDate: 06/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X  Y Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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