Provider Demographics
NPI:1841058732
Name:CECIL, NOAH
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:
Last Name:CECIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10364 E CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48877-9532
Mailing Address - Country:US
Mailing Address - Phone:989-506-9318
Mailing Address - Fax:
Practice Address - Street 1:10364 E CHURCH RD
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MI
Practice Address - Zip Code:48877-9532
Practice Address - Country:US
Practice Address - Phone:989-506-9318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst