Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | ||
N | 225X00000X | Occupational Therapist | OT005033 | GA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1053952655 |
---|---|
Provider Name | Kendra Noel |
First Address | Atlanta, GA 30342-1639 |
Second Address | Atlanta, GA 30342-1639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2019 |
Last Update Date | 21/11/2021 |