Provider Demographics
NPI:1952777617
Name:BYERS NOONAN, MANYA
Entity Type:Individual
Prefix:
First Name:MANYA
Middle Name:
Last Name:BYERS NOONAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MANYA
Other - Middle Name:
Other - Last Name:BYERS NOONAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8025 W RUSSELL RD APT 1104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1583
Mailing Address - Country:US
Mailing Address - Phone:702-204-0386
Mailing Address - Fax:
Practice Address - Street 1:8025 W RUSSELL RD APT 1104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1583
Practice Address - Country:US
Practice Address - Phone:702-204-0386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst