Provider Demographics
NPI:1336809722
Name:NOELL, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:NOELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAY
Other - Middle Name:
Other - Last Name:NOELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5638 MESA VERDE TRL
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48383-4021
Mailing Address - Country:US
Mailing Address - Phone:810-348-6136
Mailing Address - Fax:
Practice Address - Street 1:8512 N CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1310
Practice Address - Country:US
Practice Address - Phone:734-738-0897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851114116APP211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical