Provider Demographics
NPI:1891926622
Name:NOEL, SUZANNE RENEE (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:RENEE
Last Name:NOEL
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 DRY RIDGE MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:DRY RIDGE
Mailing Address - State:KY
Mailing Address - Zip Code:41035-7608
Mailing Address - Country:US
Mailing Address - Phone:859-824-0477
Mailing Address - Fax:
Practice Address - Street 1:1265 DRY RIDGE MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:DRY RIDGE
Practice Address - State:KY
Practice Address - Zip Code:41035-7608
Practice Address - Country:US
Practice Address - Phone:859-824-0477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR1339174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist