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Individual

DR. JILL CORINE NICOLINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D

Contact information

Practice address
4475 US 1 S, STE. 609, SAINT AUGUSTINE, FL 32086-7284
(828) 242-9553
(904) 342-5467
Mailing address
74 COQUINA AVE, SAINT AUGUSTINE, FL 32080-4529
(828) 242-9553

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8278
FL
103TC0700X
Clinical Psychologist
3990
NC

Other

Enumeration date
11/14/2008
Last updated
04/25/2016
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