Hi! My name is Nicole Muriel and I am truly honored that you have taken the time to visit my site and learn about me and what I can do for you.

Nicole Muriel: Mother and Wife

First a little about me! I am a wife to a loving husband and mom to two beautiful kids and 2 crazy dogs. I have been a resident in Rockland County for 15 years now. In between kids' sports and mom duties, I enjoy yoga, meditation, taking long walks, and soaking in the sun on the beach. I like to sit down with a good book, either an Adventure or a Sci-fi one, and love to express my creativity through photography and making crafts with my Cricut. Essential Oils play a huge role in me and my families' everyday lives. From health to beauty routines, the benefits are astounding.

I have always been a wellness seeker in my personal life so it was a given I would seek a Profession where I could help others in a holistic treatment approach.

Nicole Muriel

Owner/Creator of PivOTal Performance

I created PivOTal Performance to stand out from other occupational therapy services. I not only want to provide specialized treatments for pelvic floor dysfunction and LSVT-BIG but do it all in the comfort and privacy of your own home.

I began my journey at Dominican College in New York, where I received my Master's/Bachelor's degree in Occupational Therapy, in 2010. During my college career, I collaborated in a research study called the meaning of Aging in Place: from the Elderly’s Perspective. It was accepted at the 90th Annual Conference in April 2010 by the American Occupational Therapy Association. This study was the start of my passion to help others achieve their goals and improve their quality of life.

In the first 10 year career as an OTR, I gained a vast knowledge of treating neurological conditions such as Parkinson’s disease, Stroke, Multiple Sclerosis, and Traumatic Brain Injury. I soon realized that pelvic floor dysfunction was also very problematic. I wanted to offer this community more than just pelvic floor therapy. I strongly value evidence-based treatments. As a result, I discovered a program called LSVT-BIG and became certified in September 2019. I continue to further my education by working toward obtaining my BCIA pelvic floor certification.


I am BLS CPR certified. I have over 65 hours of training in the area of CBT (Cognitive Behavioral Therapy). I have taken an advanced 7-day course for Pelvic floor therapy taught by Tiffany Ellsworth Lee MA, OTR, BCB-PMD, PRPC, and Jane Kaufman PT, M.Ed, BCB-PMD. The course name was “Biofeedback evaluation and treatment for pelvic floor dysfunction as well as the accompanying lab “Hands-on Biofeedback for complex pelvic floor cases.


Hours of Operation:
Mon-Fri: 8 am - 7 pm
Sat: 9 am - 2 pm
Tel: (845) 474-2361
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© 2020 PivOTal Performance, PLLC. The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.