Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 3990 | MD |
N | 103T00000X | Psychologist | 3990 | MD |
N | 103G00000X | Clinical Psychologist | 3990 | MD |
N | 103TC0700X | Clinical Psychologist | 3990 | MD |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 3990 | MD |
N | 103TP2701X | Group Psychotherapist | 3990 | MD |
NPI | 1326178724 |
---|---|
Provider Name | Dr. Michael Wayne Nolet |
First Address | Lutherville, MD 21093-4624 |
Second Address | Lutherville, MD 21093-4624 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 08/07/2007 |