Individual
ALEXANDRA MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16414 LAKE CHURCH DR, ODESSA, FL 33556-2637
(813) 205-2715
Mailing address
812 POPLARWOOD LN, KISSIMMEE, FL 34743-8816
(407) 791-1891
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017475600
—
FL
Enumeration date
06/26/2017
Last updated
06/26/2017
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