Healthcare Provider Details

I. General information

NPI: 1225640477
Provider Name (Legal Business Name): NOELLE KENDRA-LEAH ROWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2020
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 HUNTINGTON PARK DR APT 203
COLUMBUS OH
43235-5823
US

IV. Provider business mailing address

7600 HUNTINGTON PARK DR APT 203
COLUMBUS OH
43235-5823
US

V. Phone/Fax

Practice location:
  • Phone: 410-245-5492
  • Fax:
Mailing address:
  • Phone: 410-245-5492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2001254-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2106227
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: