Provider Demographics
NPI:1922029180
Name:NOLL, REBECCA MAY (PHD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MAY
Last Name:NOLL
Suffix:
Gender:F
Credentials:PHD
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Other - Credentials:
Mailing Address - Street 1:421 N MAIN ST
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:LEEDS
Mailing Address - State:MA
Mailing Address - Zip Code:01053-9764
Mailing Address - Country:US
Mailing Address - Phone:413-584-4040
Mailing Address - Fax:413-582-3073
Practice Address - Street 1:421 N MAIN ST
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01053-9764
Practice Address - Country:US
Practice Address - Phone:413-584-4040
Practice Address - Fax:413-582-3073
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6301003109103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical