Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 283 | AL |
N | 103TC0700X | Clinical Psychologist | 283 | AL |
N | 102L00000X | Psychologist | 283 | AL |
N | 103T00000X | Psychologist | 283 | AL |
N | 103TA0700X | Adult Development & Aging Psychologist | 283 | AL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 283 | AL |
N | 103G00000X | Clinical Psychologist | 283 | AL |
N | 103TC0700X | Clinical Psychologist | 283 | AL |
N | 103TC1900X | Counseling Psychologist | 283 | AL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 283 | AL |
N | 103TF0000X | Family Psychologist | 283 | AL |
N | 103TH0100X | Health Service | 283 | AL |
N | 103TR0400X | Rehabilitation Psychologist | 283 | AL |
N | 103TS0200X | School Psychologist | 283 | AL |
NPI | 1225138720 |
---|---|
Provider Name | Dr. Robert Joseph Nolan |
First Address | Dothan, AL 36303-1908 |
Second Address | Dothan, AL 36303-1908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51071169 | BCBS (01) | AL |
R62442 | (02) | AL |