MEDICARE: JESSICA NOELLE HHP

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	171400000X	Health & Wellness Coach	231024005
2	106S00000X	Behavior Technician	RBT-26-526743

General Provider Information

NPI Number	:	1811568934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA NOELLE HHP

Provider Business Mailing Address
First Line	:	PO BOX 60189
Second Line	:	ACP #5652
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73146-0189
Country	:	US
Telephone Number	:	704-802-2301
Fax Number	:

Provider Business Practice Location Address
First Line	:	38058 N DENA DR
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-4427
Country	:	US
Telephone Number	:	704-802-2301
Fax Number	:

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

Provider Enumeration Date	:	07/09/2021
Last Update Date	:	04/09/2026

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