Provider Demographics
NPI:1659630465
Name:MCINTIRE, NATALIE MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:MCINTIRE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MARIE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:6520 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5703
Mailing Address - Country:US
Mailing Address - Phone:321-622-8792
Mailing Address - Fax:321-622-8793
Practice Address - Street 1:6520 3RD ST
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5703
Practice Address - Country:US
Practice Address - Phone:321-622-8792
Practice Address - Fax:321-622-8793
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESAS21712355S0801X
FLSA14743235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant