Provider Demographics
NPI:1689867954
Name:DICE, NOEL C (AUD)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:C
Last Name:DICE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5626 19TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2987
Mailing Address - Country:US
Mailing Address - Phone:970-301-4184
Mailing Address - Fax:970-617-1940
Practice Address - Street 1:5626 19TH ST STE B
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2987
Practice Address - Country:US
Practice Address - Phone:970-301-4184
Practice Address - Fax:970-617-1940
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD.0000505231H00000X
CO200341231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO30652570Medicaid
COP00944867OtherMEDICARE RAILROAD CARRIER PTAN
COC810154Medicare PIN
CO30652570Medicaid