| NPI | 1194324343 |
|---|---|
| Former Name | NICOLE BETHANY DORIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 025392-01) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2020029140) |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2023-03-17 |