Provider Demographics
NPI:1073227963
Name:NOBLE INTEGRATIVE HEALTH
Entity Type:Organization
Organization Name:NOBLE INTEGRATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIERRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:410-903-5229
Mailing Address - Street 1:8145 BALTIMORE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2491
Mailing Address - Country:US
Mailing Address - Phone:240-512-8627
Mailing Address - Fax:
Practice Address - Street 1:7309 BALTIMORE AVE STE 120
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-3200
Practice Address - Country:US
Practice Address - Phone:240-512-8627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1225704687OtherTHE OWNER - TIERRA HARDIN