Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1023256328 |
---|---|
Provider Name | Mrs. Lauren Kathryn Noble |
First Address | Ontario, CA 91762-2735 |
Second Address | Rancho Cucamonga, CA 91730-4449 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2009 |
Last Update Date | 26/01/2009 |