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NPI Code Detail

MEDICARE: MS. NOELLE ANN GRAVALLESE CADC-I

MEDICARE: MS. NOELLE ANN GRAVALLESE CADC-I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation PractitionerNV
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1528342854
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NOELLE ANN GRAVALLESE CADC-I
Provider Business Mailing Address
First Line : 7400 S VIRGINIA ST
Second Line :
City : RENO
State : NV
Zip : 89511-1112
Country : US
Telephone Number : 775-853-5441
Fax Number :
Provider Business Practice Location Address
First Line : 7400 S VIRGINIA ST
Second Line :
City : RENO
State : NV
Zip : 89511-1112
Country : US
Telephone Number : 775-853-5441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2011
Last Update Date : 02/10/2023

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