Provider Demographics
NPI:1972052702
Name:HIOL-HIOL, MARIE-NOEL
Entity type:Individual
Prefix:
First Name:MARIE-NOEL
Middle Name:
Last Name:HIOL-HIOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14642 QUARTZ TER NW
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-4581
Mailing Address - Country:US
Mailing Address - Phone:763-444-1683
Mailing Address - Fax:
Practice Address - Street 1:14642 QUARTZ TER NW
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-4581
Practice Address - Country:US
Practice Address - Phone:763-444-1683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities