Provider Demographics
NPI:1578125571
Name:NOBLE, MAUREEN SUE (ACMHC)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:SUE
Last Name:NOBLE
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2163 RIFLEMAN DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2792
Mailing Address - Country:US
Mailing Address - Phone:847-302-8360
Mailing Address - Fax:
Practice Address - Street 1:235 S 200 E
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2320
Practice Address - Country:US
Practice Address - Phone:801-447-4865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health