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NPI Code Detail

MEDICARE: NOELLE RICHTER

MEDICARE: NOELLE RICHTER
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1700431681
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOELLE RICHTER
Provider Business Mailing Address
First Line : 650 W GRAND AVE STE 207
Second Line :
City : ELMHURST
State : IL
Zip : 60126-1025
Country : US
Telephone Number : 844-263-1613
Fax Number : 844-263-1612
Provider Business Practice Location Address
First Line : 34475 MOUND RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-5761
Country : US
Telephone Number : 844-263-1613
Fax Number : 844-263-1612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2019
Last Update Date : 08/07/2019

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Directions to “ NOELLE RICHTER ” Practice Location

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