Provider Demographics
NPI:1518242791
Name:TODD, NOELLE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:NOELLE
Middle Name:
Last Name:TODD
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 1:19 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-3613
Mailing Address - Country:US
Mailing Address - Phone:845-489-0804
Mailing Address - Fax:
Practice Address - Street 1:19 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-3613
Practice Address - Country:US
Practice Address - Phone:845-489-0804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016587-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor