Individual
MRS. LYLLIEN AMANDA NOONAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED.
Contact information
Practice address
7504 NICHOLAS ST, SCHERERVILLE, IN 46375-3458
(219) 322-5865
Mailing address
7504 NICHOLAS STREET, SCHERERVILLE, IN 46375
(219) 322-5865
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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