Provider Demographics
NPI:1386118669
Name:JOCHIMSEN, NOELLE (OT)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:JOCHIMSEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:
Other - Last Name:JOCHIMSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:3802 DUNHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-3734
Mailing Address - Country:US
Mailing Address - Phone:469-964-8963
Mailing Address - Fax:
Practice Address - Street 1:7701 LAS COLINAS RDG STE 110
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-7552
Practice Address - Country:US
Practice Address - Phone:214-574-7848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-19
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119638225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist