Healthcare Provider Details

I. General information

NPI: 1114951944
Provider Name (Legal Business Name): SUZANNE MARIE NOONAN AU.D., CCC-A, FAAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE MARIE NOONAN-DE BLIJ MA, CCC-A, FAAA

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3913 FERRARA DR
SILVER SPRING MD
20906-4709
US

IV. Provider business mailing address

525 LONGHORN CRES
ROCKVILLE MD
20850-5704
US

V. Phone/Fax

Practice location:
  • Phone: 301-946-2434
  • Fax: 301-946-2435
Mailing address:
  • Phone: 301-926-2774
  • Fax: 301-946-2435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number770
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number770
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number770
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number770
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: