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General NPI Number Information
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NPI Number | 1841528874
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Entity Type | Individual
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Provider Name | NICOLLE ANNE DELEO PSY D
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Gender | Female
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Dates
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Enumeration Date | 12/02/2009
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 2755 E OAKLAND PARK BLVD STE 225
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1629
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Country | US
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Telephone | 954-440-7828
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Fax |
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Provider Business Mailing Address
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Address Line | 2755 E OAKLAND PARK BLVD STE 225
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1629
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Country | US
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Telephone | 954-990-7673
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10032
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY8799
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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