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NPI Code Detail

MEDICARE: NOELLE MONIQUE PARKER

MEDICARE: NOELLE MONIQUE PARKER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystBH005289PA
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1114448883
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOELLE MONIQUE PARKER
Provider Business Mailing Address
First Line : 1003 WYOMING AVE
Second Line :
City : FORTY FORT
State : PA
Zip : 18704-4002
Country : US
Telephone Number : 570-846-0455
Fax Number :
Provider Business Practice Location Address
First Line : 1003 WYOMING AVE
Second Line :
City : FORTY FORT
State : PA
Zip : 18704-4002
Country : US
Telephone Number : 570-846-0455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2017
Last Update Date : 03/15/2021

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Directions to “ NOELLE MONIQUE PARKER ” Practice Location

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