Provider Demographics
NPI:1992954614
Name:TANOUYE, NOELANI (OTR/L)
Entity type:Individual
Prefix:
First Name:NOELANI
Middle Name:
Last Name:TANOUYE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 ABBOT KINNEY BLVD
Mailing Address - Street 2:APT. #23
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-4791
Mailing Address - Country:US
Mailing Address - Phone:909-979-4765
Mailing Address - Fax:
Practice Address - Street 1:6400 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1571
Practice Address - Country:US
Practice Address - Phone:818-763-0136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT10215174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist