Healthcare Provider Details

I. General information

NPI: 1073354361
Provider Name (Legal Business Name): MOLLY REBECCA NOON BCBA, LBA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 N 155TH ST STE B
BASEHOR KS
66007-7100
US

IV. Provider business mailing address

1106 N 155TH ST STE B
BASEHOR KS
66007-7100
US

V. Phone/Fax

Practice location:
  • Phone: 913-662-7071
  • Fax:
Mailing address:
  • Phone: 913-662-7071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2343
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number00707
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: