Provider Demographics
NPI:1700232287
Name:NOBLES, KRISTEN R
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:R
Last Name:NOBLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 DEER CREEK CV
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:LA
Mailing Address - Zip Code:71225-9608
Mailing Address - Country:US
Mailing Address - Phone:318-235-1791
Mailing Address - Fax:
Practice Address - Street 1:108 DEER CREEK CV
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:LA
Practice Address - Zip Code:71225-9608
Practice Address - Country:US
Practice Address - Phone:318-235-1791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-157103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst