Individual
MR. GREGORY EDWARD NORDLOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
220 ABRAHAM FLEXNER WAY FL 6, LOUISVILLE, KY 40202-3826
(502) 582-7484
(502) 582-7646
Mailing address
100 EAST LIBERTY STREET, SUITE 800, LOUISVILLE, KY 40202-1428
(502) 582-7484
(502) 582-7646
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
130825
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300006181
—
IN
05
—
7100479880
—
KY
01
—
K252480
MEDICARE
KY
01
—
P01922742
RR MEDICARE
KY
Enumeration date
07/25/2007
Last updated
04/17/2018
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