Provider Demographics
NPI:1518263805
Name:REICH-NOBLES, JENNA LEIGH (DPT)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LEIGH
Last Name:REICH-NOBLES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:1460 RITCHIE HWY STE 113
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2704
Practice Address - Country:US
Practice Address - Phone:410-626-8350
Practice Address - Fax:410-626-8351
Is Sole Proprietor?:No
Enumeration Date:2011-02-03
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT871210225100000X
MD23924225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist