Provider Demographics
NPI:1023786399
Name:NOBLES, NANISHA (RBT)
Entity type:Individual
Prefix:
First Name:NANISHA
Middle Name:
Last Name:NOBLES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30306 RATTANA CT
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-1368
Mailing Address - Country:US
Mailing Address - Phone:813-451-7425
Mailing Address - Fax:
Practice Address - Street 1:30306 RATTANA CT
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-1368
Practice Address - Country:US
Practice Address - Phone:813-451-7425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-183112106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty