Provider Demographics
NPI:1104012111
Name:NOE, DAWN (LD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:NOE
Suffix:
Gender:F
Credentials:LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10685 CARNEGIE AVE
Mailing Address - Street 2:X20
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3018
Mailing Address - Country:US
Mailing Address - Phone:216-445-8928
Mailing Address - Fax:216-444-3474
Practice Address - Street 1:10685 CARNEGIE AVE
Practice Address - Street 2:X20
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-3018
Practice Address - Country:US
Practice Address - Phone:216-445-8928
Practice Address - Fax:216-444-3474
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD-5800133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered