Provider Demographics
NPI:1518668821
Name:BROWN, NOELLE KRISTINE (MA-CF)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:KRISTINE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 KETTERING BLVD
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-2015
Mailing Address - Country:US
Mailing Address - Phone:937-253-4178
Mailing Address - Fax:
Practice Address - Street 1:3500 KETTERING BLVD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-2015
Practice Address - Country:US
Practice Address - Phone:937-253-4178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist