Provider Demographics
NPI:1184858946
Name:DINALLO, DORIS M (RN, LCADC, LPC, BCPC)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:M
Last Name:DINALLO
Suffix:
Gender:F
Credentials:RN, LCADC, LPC, BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 HOLLY LANE
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009
Mailing Address - Country:US
Mailing Address - Phone:973-997-9201
Mailing Address - Fax:
Practice Address - Street 1:1425 POMPTON AVE FL 2
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1043
Practice Address - Country:US
Practice Address - Phone:973-997-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC0002100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional