Provider Demographics
NPI:1104295690
Name:NOULLET, CHRISTOPHER
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:NOULLET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 VINCENT ST.
Mailing Address - Street 2:21 MDOS/SGOW - ATTN: MENTAL HEALTH
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1540
Mailing Address - Country:US
Mailing Address - Phone:719-556-7804
Mailing Address - Fax:877-813-1756
Practice Address - Street 1:559 VINCENT ST.
Practice Address - Street 2:21 MDOS/SGOW - ATTN: MENTAL HEALTH
Practice Address - City:PETERSON AFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-556-7804
Practice Address - Fax:877-813-1756
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist