Provider Demographics
NPI:1992394613
Name:NOLETTE, TERRI
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:NOLETTE
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 1:160 CENTER DEPOT RD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-1214
Mailing Address - Country:US
Mailing Address - Phone:508-320-6336
Mailing Address - Fax:
Practice Address - Street 1:160 CENTER DEPOT RD
Practice Address - Street 2:
Practice Address - City:CHARLTON
Practice Address - State:MA
Practice Address - Zip Code:01507-1214
Practice Address - Country:US
Practice Address - Phone:508-320-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician