Provider Demographics
NPI:1972071413
Name:HAM, NOELLE (DACM)
Entity Type:Individual
Prefix:DR
First Name:NOELLE
Middle Name:
Last Name:HAM
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2698 KINGS LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-5492
Mailing Address - Country:US
Mailing Address - Phone:239-719-0550
Mailing Address - Fax:
Practice Address - Street 1:201 8TH ST S STE 307
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6117
Practice Address - Country:US
Practice Address - Phone:239-719-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-02
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3801171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist