Provider Demographics
NPI:1417334327
Name:NOONAN, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:NOONAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4793 SAND MOUNTAIN PT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-8834
Mailing Address - Country:US
Mailing Address - Phone:719-291-9302
Mailing Address - Fax:
Practice Address - Street 1:4793 SAND MOUNTAIN PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-8834
Practice Address - Country:US
Practice Address - Phone:719-291-9302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0104720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health