Provider Demographics
NPI:1326218975
Name:CROWNOVER, NOELLE RAYE (OTR/L)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:RAYE
Last Name:CROWNOVER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 WARNER AVE
Mailing Address - Street 2:#83
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-5257
Mailing Address - Country:US
Mailing Address - Phone:714-842-4422
Mailing Address - Fax:
Practice Address - Street 1:6600 WARNER AVE
Practice Address - Street 2:#83
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5257
Practice Address - Country:US
Practice Address - Phone:714-842-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA864225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist