Provider Demographics
NPI:1891036794
Name:NOE, LILLIAN RACHEL
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:RACHEL
Last Name:NOE
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 1:2854 KALMIA AVE
Mailing Address - Street 2:APT 208
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-5907
Mailing Address - Country:US
Mailing Address - Phone:617-823-6854
Mailing Address - Fax:
Practice Address - Street 1:2460 S VINE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5264
Practice Address - Country:US
Practice Address - Phone:303-871-5634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health