Provider Demographics
NPI:1114105350
Name:NOEL, HANIYFA REBEKAH (SLP)
Entity Type:Individual
Prefix:MISS
First Name:HANIYFA
Middle Name:REBEKAH
Last Name:NOEL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 ANTRIM CT NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-5840
Mailing Address - Country:US
Mailing Address - Phone:917-626-0185
Mailing Address - Fax:
Practice Address - Street 1:3111 ANTRIM CT NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-5840
Practice Address - Country:US
Practice Address - Phone:917-626-0185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0179201235Z00000X
GASLP008385235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist