Provider Demographics
NPI:1861877136
Name:BOEHLE, NOELLE (SLP)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:BOEHLE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:
Other - Last Name:LINDAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5285
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-5285
Mailing Address - Country:US
Mailing Address - Phone:308-382-0344
Mailing Address - Fax:308-382-3241
Practice Address - Street 1:3601 CIMARRON PLZ
Practice Address - Street 2:SUITE 105
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-2884
Practice Address - Country:US
Practice Address - Phone:402-463-2077
Practice Address - Fax:402-463-2062
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE458235Z00000X
NE1818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist