Provider Demographics
NPI:1487325239
Name:NOBLE, CHANTELLE W (MASTERS)
Entity type:Individual
Prefix:MS
First Name:CHANTELLE
Middle Name:W
Last Name:NOBLE
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 AVENUE H APT 6F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3242
Mailing Address - Country:US
Mailing Address - Phone:347-362-4389
Mailing Address - Fax:
Practice Address - Street 1:3210 AVENUE H APT 6F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3242
Practice Address - Country:US
Practice Address - Phone:347-362-4389
Practice Address - Fax:914-229-2022
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician