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NPI Code Detail

MEDICARE: CORAZON LAFERN NOYOLA LCSW

MEDICARE: CORAZON LAFERN NOYOLA LCSW
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
11041C0700XClinical Social WorkerLW61170685WA

General Provider Information

NPI Number : 1578007084
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORAZON LAFERN NOYOLA LCSW
Provider Business Mailing Address
First Line : 3950 KEENE RD
Second Line :
City : WEST RICHLAND
State : WA
Zip : 99353-4901
Country : US
Telephone Number : 509-942-3130
Fax Number : 509-628-8335
Provider Business Practice Location Address
First Line : 3950 KEENE RD
Second Line :
City : WEST RICHLAND
State : WA
Zip : 99353-4901
Country : US
Telephone Number : 509-942-3130
Fax Number : 509-628-8335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2016
Last Update Date : 11/05/2025

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Directions to “ CORAZON LAFERN NOYOLA LCSW” Practice Location

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