Provider Demographics
NPI:1154691418
Name:NOLL, BARBRA C (CMT)
Entity type:Individual
Prefix:
First Name:BARBRA
Middle Name:C
Last Name:NOLL
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 8TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-2405
Mailing Address - Country:US
Mailing Address - Phone:727-290-6116
Mailing Address - Fax:
Practice Address - Street 1:265 8TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-2405
Practice Address - Country:US
Practice Address - Phone:727-290-6116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor