Provider Demographics
NPI:1427781590
Name:NOEL THERAPY SERVICES LLC
Entity type:Organization
Organization Name:NOEL THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:678-713-8204
Mailing Address - Street 1:173 LAKESTONE PKWY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-5427
Mailing Address - Country:US
Mailing Address - Phone:678-713-8204
Mailing Address - Fax:
Practice Address - Street 1:1400 HEMBREE RD STE 130
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5711
Practice Address - Country:US
Practice Address - Phone:404-671-8499
Practice Address - Fax:404-671-8490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003264045AMedicaid