Individual
NOAH JORDAN LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
LLMSW
Contact information
Practice address
916 CORA ST, WYANDOTTE, MI 48192-2820
(989) 820-2017
Mailing address
916 CORA ST, WYANDOTTE, MI 48192-2820
(989) 820-2017
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6851121119
—
MI
Enumeration date
04/03/2026
Last updated
04/03/2026
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