Provider Demographics
NPI:1376568386
Name:NICOLINO, DONNA MARIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARIE
Last Name:NICOLINO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:91 SOUTH ST
Mailing Address - Street 2:APT 1
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-3455
Mailing Address - Country:US
Mailing Address - Phone:347-727-8865
Mailing Address - Fax:
Practice Address - Street 1:91 SOUTH ST
Practice Address - Street 2:APT 1
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-3455
Practice Address - Country:US
Practice Address - Phone:860-456-2261
Practice Address - Fax:860-450-1357
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical