Individual
ROBERTA NOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAPT, CPED
Contact information
Practice address
80 TURNPIKE DR, UNIT 1, MIDDLEBURY, CT 06762-1830
(203) 758-8307
(203) 758-8394
Mailing address
80 TURNPIKE DR, UNIT 1, MIDDLEBURY, CT 06762-1830
(203) 758-8307
(203) 758-8394
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
225100000X
Physical Therapist
Primary
003621
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004137338
—
CT
01
—
12DME0603CT01
ANTHEM BLUE CROSS BLUE SHIELD
CT
Enumeration date
02/09/2008
Last updated
01/30/2009
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