Individual
ALEXANDRA O'NEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11335 VILLAGE BROOK DR, RIVERVIEW, FL 33579-7191
(702) 787-6872
Mailing address
11335 VILLAGE BROOK DR, RIVERVIEW, FL 33579-7191
(702) 787-6872
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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