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General NPI Number Information
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NPI Number | 1669732947
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Entity Type | Individual
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Provider Name | LORELEI HOLLY NOBLE LMT
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Gender | Female
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 2500 W WILLIAM CANNON DR SUITE 601
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City | AUSTIN
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State | TX
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Zip | 78745-5257
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Country | US
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Telephone | 817-726-1981
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Fax |
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Provider Business Mailing Address
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Address Line | 2809 W WILLIAM CANNON DR F204
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City | AUSTIN
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State | TX
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Zip | 78745-5140
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Country | US
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Telephone | 817-726-1981
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT033798
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License Number State | TX
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