Provider Demographics
NPI:1639489255
Name:NICOLETTI, JAMEE NOELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMEE
Middle Name:NOELLE
Last Name:NICOLETTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1520 S DOBSON RD STE 203
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4726
Mailing Address - Country:US
Mailing Address - Phone:480-412-8080
Mailing Address - Fax:480-412-8081
Practice Address - Street 1:1520 S DOBSON RD STE 203
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202
Practice Address - Country:US
Practice Address - Phone:480-412-8080
Practice Address - Fax:480-412-8081
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-16
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY018797103G00000X
AZPSY-004438103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist