Provider Demographics
NPI:1831661461
Name:NOONAN, MIRANDA (MSW)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:NOONAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 NEWCASTLE DR APT 1
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5464
Mailing Address - Country:US
Mailing Address - Phone:817-773-6274
Mailing Address - Fax:
Practice Address - Street 1:14 NEWCASTLE DR APT 1
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5464
Practice Address - Country:US
Practice Address - Phone:817-773-6274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-20
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1233821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical