Provider Demographics
NPI:1598767261
Name:NOLL, LIEF AARON (PHD)
Entity Type:Individual
Prefix:DR
First Name:LIEF
Middle Name:AARON
Last Name:NOLL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CENTRAL TER
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-2628
Mailing Address - Country:US
Mailing Address - Phone:513-821-2347
Mailing Address - Fax:
Practice Address - Street 1:2330 VICTORY PKWY
Practice Address - Street 2:STE 500
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2839
Practice Address - Country:US
Practice Address - Phone:513-221-2330
Practice Address - Fax:513-221-8954
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5972103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist