Provider Demographics
NPI:1487755989
Name:NOOE, MARIKATHRYN NMN (MSE)
Entity type:Individual
Prefix:MS
First Name:MARIKATHRYN
Middle Name:NMN
Last Name:NOOE
Suffix:
Gender:F
Credentials:MSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 MIDWAY RD # C
Mailing Address - Street 2:
Mailing Address - City:MENASHA
Mailing Address - State:WI
Mailing Address - Zip Code:54952-1128
Mailing Address - Country:US
Mailing Address - Phone:920-722-8150
Mailing Address - Fax:920-722-0142
Practice Address - Street 1:1244 MIDWAY RD # C
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952-1128
Practice Address - Country:US
Practice Address - Phone:920-722-8150
Practice Address - Fax:920-722-0142
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43582300Medicaid