Healthcare Provider Details

I. General information

NPI: 1992625610
Provider Name (Legal Business Name): NOAH JACOB LAIRD BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 W PITT ST
BEDFORD PA
15522-1246
US

IV. Provider business mailing address

644 W PITT ST
BEDFORD PA
15522-1246
US

V. Phone/Fax

Practice location:
  • Phone: 814-494-9337
  • Fax:
Mailing address:
  • Phone: 814-494-9337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: