Healthcare Provider Details

I. General information

NPI: 1750722054
Provider Name (Legal Business Name): AUBREY NOBLE M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2013
Last Update Date: 12/09/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 KIRBY WHITTEN RD STE D
BARTLETT TN
38134-2853
US

IV. Provider business mailing address

3205 KIRBY WHITTEN RD STE D
BARTLETT TN
38134-2853
US

V. Phone/Fax

Practice location:
  • Phone: 901-430-5009
  • Fax:
Mailing address:
  • Phone: 901-430-5009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4960
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: