Healthcare Provider Details

I. General information

NPI: 1255245932
Provider Name (Legal Business Name): ALEJANDRA OYOLA RICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 W LAKE MARY BLVD STE 113&117
LAKE MARY FL
32746-3567
US

IV. Provider business mailing address

2601 W LAKE MARY BLVD STE 113&117
LAKE MARY FL
32746-3567
US

V. Phone/Fax

Practice location:
  • Phone: 407-328-1005
  • Fax:
Mailing address:
  • Phone: 407-328-1005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberISW19254
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: