Provider Information for 1316214794
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ALEXANDRA MARIE POOLT LCSW
Sex: Female
NPI: 1316214794
Last Updated: 2023-12-08
Certification Date: 2023-12-08
Certification Date: 2023-12-08
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1316214794 | ||||||||||||
| Enumeration Date | 2011-11-29 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 9460 MEADOWOOD DR APT 101 FORT PIERCE, FL 34951-2943 United States Phone: 917-328-2757 | Fax: | ||||||||||||
| Primary Practice Address | 9460 MEADOWOOD DR APT 101 FORT PIERCE, FL 34951-2943 United States Phone: 917-328-2757 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 322 W 137TH ST | ||||||||||||
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