Provider Demographics
NPI:1083218572
Name:NOYES, BRIDGET CATHLEEN
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:CATHLEEN
Last Name:NOYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 CLINTON AVE APT REAR
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6780
Mailing Address - Country:US
Mailing Address - Phone:508-562-1673
Mailing Address - Fax:
Practice Address - Street 1:1235 LAKE PLAZA DR STE 231
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3517
Practice Address - Country:US
Practice Address - Phone:719-434-8093
Practice Address - Fax:719-445-0942
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11338225700000X
CO0023677225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist