Provider Demographics
NPI:1518641562
Name:NOE, SARAH JANE (RBT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:NOE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-1303
Mailing Address - Country:US
Mailing Address - Phone:573-513-1356
Mailing Address - Fax:
Practice Address - Street 1:7477 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY CITY
Practice Address - State:MO
Practice Address - Zip Code:63130-4065
Practice Address - Country:US
Practice Address - Phone:314-410-9670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORBT-21-197657106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician