Provider Demographics
NPI:1952540064
Name:DINIS, NICOLE K (SLP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:K
Last Name:DINIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GERSTEIN ST
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-2419
Mailing Address - Country:US
Mailing Address - Phone:914-271-5184
Mailing Address - Fax:
Practice Address - Street 1:8 GERSTEIN ST
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2419
Practice Address - Country:US
Practice Address - Phone:914-271-5184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016058-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist