MEDICARE: NOAH TOWNES

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	:	1922753268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH TOWNES

Provider Business Mailing Address
First Line	:	4535 S LAKESHORE DR STE 1A
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7046
Country	:	US
Telephone Number	:	602-899-1519
Fax Number	:

Provider Business Practice Location Address
First Line	:	4535 S LAKESHORE DR
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-8340
Country	:	US
Telephone Number	:	248-436-4400
Fax Number	:

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

Provider Enumeration Date	:	02/15/2022
Last Update Date	:	04/11/2023

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Directions to “ NOAH TOWNES ” Practice Location

Language	Start Address	Practice Location

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