Individual
CLINTON M NOWICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGY ASSISTANT
Contact information
Practice address
3840 RUCKRIEGEL PKWY STE 105, LOUISVILLE, KY 40299-6836
(502) 261-7227
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 559-9425
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
277977
KY
Other
Enumeration date
08/13/2019
Last updated
02/22/2024
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