Provider Demographics
NPI:1033786975
Name:MOREIRA COOLEY, ALEXANDRA NELDA (MA, BCABA)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:NELDA
Last Name:MOREIRA COOLEY
Suffix:
Gender:F
Credentials:MA, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WILDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3221
Mailing Address - Country:US
Mailing Address - Phone:386-227-6485
Mailing Address - Fax:
Practice Address - Street 1:3440 US HIGHWAY 1 S STE 202
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-6363
Practice Address - Country:US
Practice Address - Phone:877-823-4283
Practice Address - Fax:352-332-8589
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-25-15982106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst