Provider Demographics
NPI:1437803368
Name:NOONAN, LILLIAN (COUNSELOR-IN-TRAININ)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:NOONAN
Suffix:
Gender:F
Credentials:COUNSELOR-IN-TRAININ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 KELTON ST APT 31
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-4327
Mailing Address - Country:US
Mailing Address - Phone:262-716-6539
Mailing Address - Fax:
Practice Address - Street 1:460 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-8130
Practice Address - Country:US
Practice Address - Phone:617-745-2779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program