MEDICARE: DAWNELLE NOYES

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1598200560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWNELLE NOYES

Provider Business Mailing Address
First Line	:	2035 SW 75TH ST STE B
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32607-3425
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 DUNLAWTON AVE
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-4220
Country	:	US
Telephone Number	:	877-823-4283
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2016
Last Update Date	:	12/30/2016

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Directions to “ DAWNELLE NOYES ” Practice Location

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