| Doctor Name: | NICHOLAS J GAMBINO |
| NPI Number: | 1609030204 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW |
| License Number: | I-0001586 |
| Business Practice Address: | 4301 State Route 725 Ste B Bellbrook, OH - 453051552 |
| Business Phone Number: | 9378489858 |
| Business Fax Number: | 9378482080 |
| Mailing Address: | 511 N Heincke Rd, MIAMISBURG |
| State: | OH |
| Postal Code: | 453422639 |
| Phone Number: | 9378597062 |
| Fax Number: | |
| NPI Enumeration Date: | 07/12/2008 |
| NPI Last Update Date: | 07/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | I-0001586 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |