Provider Demographics
NPI:1265005995
Name:MORRIS, NOELLE (CMT, SEP, CHP)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CMT, SEP, CHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-5022
Mailing Address - Country:US
Mailing Address - Phone:650-776-4688
Mailing Address - Fax:
Practice Address - Street 1:804 ARBOR RD
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-5022
Practice Address - Country:US
Practice Address - Phone:650-776-4688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32540225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist