Doctor Name: | NICOLE CANARY-DIGIRONIMO |
NPI Number: | 1053339234 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 37PC00294100 |
Business Practice Address: | 35 Beaverson Blvd Bldg 1-d Brick, NJ - 087237812 |
Business Phone Number: | 7329207933 |
Business Fax Number: | |
Mailing Address: | 35 Beaverson Blvd, Bldg 1-d BRICK |
State: | NJ |
Postal Code: | 087237812 |
Phone Number: | 7329207933 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 37PC00294100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |