Provider Demographics
NPI:1861515124
Name:SETZER, NICOLE JACQUELINE (PHD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:JACQUELINE
Last Name:SETZER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BONNIE BROOK RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-1505
Mailing Address - Country:US
Mailing Address - Phone:203-227-6310
Mailing Address - Fax:
Practice Address - Street 1:83 EAST AVE
Practice Address - Street 2:SUITE 217
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-4902
Practice Address - Country:US
Practice Address - Phone:203-571-8142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002700103TB0200X
NY013989-1103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral