Provider Demographics
NPI:1669809562
Name:DIGIORE, NICOLE OKRAGLY
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:OKRAGLY
Last Name:DIGIORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ANTHONY BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-1202
Mailing Address - Country:US
Mailing Address - Phone:201-207-2088
Mailing Address - Fax:
Practice Address - Street 1:20 ANTHONY BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:NJ
Practice Address - Zip Code:07035-1202
Practice Address - Country:US
Practice Address - Phone:201-207-2088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-09
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00445000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0000Other0000