Provider Demographics
NPI:1861697674
Name:NOBLE, HEATHER LYNN (PHD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:NOBLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 TROOST ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-2499
Mailing Address - Country:US
Mailing Address - Phone:816-235-6467
Mailing Address - Fax:816-235-5534
Practice Address - Street 1:4825 TROOST ST
Practice Address - Street 2:SUITE 206
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-2499
Practice Address - Country:US
Practice Address - Phone:816-235-6467
Practice Address - Fax:816-235-5534
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004024737103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist