Provider Demographics
NPI:1851446124
Name:SANDALL, G. NOHL (PH D)
Entity Type:Individual
Prefix:DR
First Name:G.
Middle Name:NOHL
Last Name:SANDALL
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 884
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:WY
Mailing Address - Zip Code:83110-0884
Mailing Address - Country:US
Mailing Address - Phone:307-885-3914
Mailing Address - Fax:
Practice Address - Street 1:206 MADISON ST.
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:WY
Practice Address - Zip Code:83110-0884
Practice Address - Country:US
Practice Address - Phone:307-885-3914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY158103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist