Individual
JESSICA NOELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HHP
Contact information
Practice address
38058 N DENA DR, SAN TAN VALLEY, AZ 85140-4427
(704) 802-2301
Mailing address
PO BOX 60189, ACP #5652, OKLAHOMA CITY, OK 73146-0189
(704) 802-2301
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-26-526743
—
171400000X
Health & Wellness Coach
Primary
231024005
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/09/2021
Last updated
04/09/2026
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