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General NPI Number Information
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NPI Number | 1144747775
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Entity Type | Individual
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Provider Name | JENNIFER NOON
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Gender | Female
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 08/24/2017
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Provider Practice Location Address
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Address Line | 850 LA SCONSA DR
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City | LAS VEGAS
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State | NV
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Zip | 89138-7562
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Country | US
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Telephone | 702-526-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 814 SPIKENARD DR
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City | HENDERSON
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State | NV
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Zip | 89002-9107
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Country | US
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Telephone | 541-218-9129
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 17-0930
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License Number State | NV
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