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Individual
GREGG NODELMAN
Active
Individual
GREGG NODELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC, LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000973
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008038052
—
CT
Enumeration date
12/13/2011
Last updated
02/07/2017
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