Provider Demographics
NPI:1972240190
Name:DWYER-NOBLE, ELIZABETH A (MASTERS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:DWYER-NOBLE
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:DWYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-1910
Mailing Address - Country:US
Mailing Address - Phone:914-953-2229
Mailing Address - Fax:
Practice Address - Street 1:3 WARREN ST
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-1910
Practice Address - Country:US
Practice Address - Phone:914-953-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst