| Doctor Name: | DR. NICOLE DOCK |
| NPI Number: | 1619376852 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 35SI00529200 |
| Business Practice Address: | 111 Celestino Ct Blackwood, NJ - 080124435 |
| Business Phone Number: | 8627637965 |
| Business Fax Number: | |
| Mailing Address: | 111 Celestino Ct, BLACKWOOD |
| State: | NJ |
| Postal Code: | 080124435 |
| Phone Number: | 8627637965 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2014 |
| NPI Last Update Date: | 08/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 35SI00529200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |