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Individual

DR. JOSEPH WM NUSSBAUMER JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
627 S MAIN AVE, GROVELAND, FL 34736-2731
(352) 429-5600
(352) 429-1206
Mailing address
627 S MAIN AVE, GROVELAND, FL 34736-2731
(352) 429-5600
(352) 429-1206

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
CPY0003010493-FACCT
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
034015
VALUE OPTIONS
Enumeration date
08/14/2007
Last updated
08/14/2007
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