Provider Demographics
NPI:1407976103
Name:BARB, NOELLA MARION (MFTI)
Entity Type:Individual
Prefix:MRS
First Name:NOELLA
Middle Name:MARION
Last Name:BARB
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13030 CHOLLA DR
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-5433
Mailing Address - Country:US
Mailing Address - Phone:760-905-0856
Mailing Address - Fax:
Practice Address - Street 1:13030 CHOLLA DR
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-5433
Practice Address - Country:US
Practice Address - Phone:760-905-0856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112273106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist