Provider Demographics
NPI:1134683261
Name:NOON, SUSANNA HARRIS (AAHCC)
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:HARRIS
Last Name:NOON
Suffix:
Gender:F
Credentials:AAHCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2131
Mailing Address - Country:US
Mailing Address - Phone:978-969-1481
Mailing Address - Fax:
Practice Address - Street 1:14 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2131
Practice Address - Country:US
Practice Address - Phone:978-969-1481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAN163374J00000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula