Provider Demographics
NPI:1831660133
Name:NOBLES, MYLES B (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:MYLES
Middle Name:B
Last Name:NOBLES
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14140 W SIDE BLVD APT 309
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6222
Mailing Address - Country:US
Mailing Address - Phone:301-615-2529
Mailing Address - Fax:
Practice Address - Street 1:14140 W SIDE BLVD APT 309
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-6222
Practice Address - Country:US
Practice Address - Phone:301-615-2529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-12
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09002235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist