Provider Demographics
NPI:1093938797
Name:NOEL, STEPHANIE ANNE (PTA)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:ANNE
Last Name:NOEL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 COTTAGE DR
Mailing Address - Street 2:
Mailing Address - City:WEST YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02673
Mailing Address - Country:US
Mailing Address - Phone:508-775-3924
Mailing Address - Fax:
Practice Address - Street 1:130 NORTH ST
Practice Address - Street 2:CAPE COD HOSPITAL REHAB CENTER
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-771-9600
Practice Address - Fax:508-775-1753
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1105225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant