Doctor Name: | MS. NICOLE MARIE ROBELLO |
NPI Number: | 1326440116 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PSY 1489 |
Business Practice Address: | 604 Maunaloa Hwy #c Kaunakakai, HI - 96748 |
Business Phone Number: | 8085603653 |
Business Fax Number: | |
Mailing Address: | Po Box 130, KAUNAKAKAI |
State: | HI |
Postal Code: | 967480130 |
Phone Number: | 8085603653 |
Fax Number: | |
NPI Enumeration Date: | 09/23/2014 |
NPI Last Update Date: | 09/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY 1489 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |