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Individual

ALEXA NICOLE POLANCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13121 ATLANTIC BLVD STE 200, JACKSONVILLE, FL 32225-0102
(904) 416-8921
Mailing address
13121 ATLANTIC BLVD STE 200, JACKSONVILLE, FL 32225-0102
(904) 416-8921

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-403112
FL

Other

Enumeration date
01/06/2025
Last updated
01/06/2025
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