Provider Demographics
NPI:1730228024
Name:NOYES, GINNY D (M ED)
Entity type:Individual
Prefix:MRS
First Name:GINNY
Middle Name:D
Last Name:NOYES
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:MISS
Other - First Name:VIRGINIA
Other - Middle Name:DIANNE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M ED
Mailing Address - Street 1:525 S MIDDLETON RD
Mailing Address - Street 2:SUITE #102
Mailing Address - City:MIDDLETON
Mailing Address - State:ID
Mailing Address - Zip Code:83644-5993
Mailing Address - Country:US
Mailing Address - Phone:208-585-3062
Mailing Address - Fax:208-453-1021
Practice Address - Street 1:525 S MIDDLETON RD
Practice Address - Street 2:SUITE #102
Practice Address - City:MIDDLETON
Practice Address - State:ID
Practice Address - Zip Code:83644-5993
Practice Address - Country:US
Practice Address - Phone:208-585-3062
Practice Address - Fax:208-453-1021
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-2728101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health