Healthcare Provider Details

I. General information

NPI: 1033786975
Provider Name (Legal Business Name): ALEXANDRA NELDA MOREIRA COOLEY MA, BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 05/26/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 US HIGHWAY 1 S STE 202
ST AUGUSTINE FL
32086-6363
US

IV. Provider business mailing address

8 WILDWOOD LN
PALM COAST FL
32137-3221
US

V. Phone/Fax

Practice location:
  • Phone: 877-823-4283
  • Fax: 352-332-8589
Mailing address:
  • Phone: 386-227-6485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-15982
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: