Individual
DONALD M NOCKLEBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3625 N 16TH ST, SUITE 104, PHOENIX, AZ 85016-6443
(602) 271-6165
Mailing address
3625 N 16TH ST, SUITE 104, PHOENIX, AZ 85016-6443
(602) 271-6165
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1583
AZ
103G00000X
Clinical Neuropsychologist
178
MT
103G00000X
Clinical Neuropsychologist
33310
TX
103TA0700X
Adult Development & Aging Psychologist
1583
AZ
103TA0700X
Adult Development & Aging Psychologist
178
MT
103TA0700X
Adult Development & Aging Psychologist
33310
TX
Other
Enumeration date
05/01/2007
Last updated
04/23/2012
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