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General NPI Number Information
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NPI Number | 1962626614
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Entity Type | Individual
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Provider Name | C. RICHARD NOBEL PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 649 JONES RD
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City | VESTAL
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State | NY
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Zip | 13850-5226
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Country | US
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Telephone | 607-379-0045
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Fax | 607-748-7997
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Provider Business Mailing Address
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Address Line | 649 JONES RD
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City | VESTAL
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State | NY
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Zip | 13850-5226
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Country | US
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Telephone | 607-379-0045
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Fax | 607-748-7997
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 010936
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS005849L
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License Number State | PA
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