Provider Demographics
NPI:1023392701
Name:NOLL, PAULA JODOIN (BS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JODOIN
Last Name:NOLL
Suffix:
Gender:F
Credentials:BS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 ROUTE 11A
Mailing Address - Street 2:
Mailing Address - City:CRARYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12521-5510
Mailing Address - Country:US
Mailing Address - Phone:518-325-2800
Mailing Address - Fax:
Practice Address - Street 1:73 ROUTE 11A
Practice Address - Street 2:
Practice Address - City:CRARYVILLE
Practice Address - State:NY
Practice Address - Zip Code:12521-5510
Practice Address - Country:US
Practice Address - Phone:518-325-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005322235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist