Individual
MARK NOAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
2050A 2ND ST SE, KIRTLAND AFB, NM 87117-5003
(302) 677-2674
Mailing address
300 TUSKEGEE BLVD, DOVER, DE 19902-5003
(302) 677-2674
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PSY.0004023
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/15/2009
Last updated
06/13/2022
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