Nicole Muriel OTR/L HSP

Owner/Creator of PivOTal Performance


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.

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 my 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.

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 provide my clients with the flexibility of offering a variety of services/treatments. We service New York and New Jersey. Our Office in New York is located at 54 South Liberty Drive, Stony Point, NY, 10980. We provide in-home treatments only to all New Jersey Residents. 


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 my 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 such a prevalent issue. Being a woman who went through my own pelvic floor issues, I was compelled to help empower other women, who may be dealing with pelvic floor issues. I believe strongly in a whole-body approach when evaluating and providing treatment for my clients. I created PivOTal performance to be a support for women and individuals with Parkinson's disease and other neurological conditions. 


I am currently a sacroiliac joint specialist.  I am BLS CPR certified. I have completed an advanced 7-day course for Biofeedback evaluation and treatment for pelvic floor dysfunction Pelvic floor therapy taught by Tiffany Ellsworth Lee MA, OTR, BCB-PMD, PRPC, and Jane Kaufman PT, M.Ed, BCB-PMD. I have taken Herman and Wallace Pelvic Floor 1 & 2. I have over 65 hours of training in the area of CBT (Cognitive Behavioral Therapy).