Individual
PAMELA V NOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
30432 EUCLID AVE, SUITE 221, WICKLIFFE, OH 44092-1552
(440) 585-4500
(330) 499-2536
Mailing address
3872 E HARBOR LIGHT LANDING DR, SUITE 221, PORT CLINTON, OH 43452-3877
(419) 734-3333
(877) 734-2030
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5343
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000137855
ANTHEM
OH
05
—
2060157
—
OH
01
—
290600000
MAGELLAN
OH
01
—
6100374
EVERCARE
OH
01
—
680009560
RAILROAD MEDICARE
OH
01
—
92895
QUALCHOICE
OH
Enumeration date
10/18/2006
Last updated
09/29/2016
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