Provider Demographics
NPI:1316391469
Name:AGUILAR, ALEXANDRA (MSW, U/S)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:MSW, U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 S JACKSON AVE
Mailing Address - Street 2:APT 21 D
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-1816
Mailing Address - Country:US
Mailing Address - Phone:979-922-0278
Mailing Address - Fax:
Practice Address - Street 1:1711 S JACKSON AVE
Practice Address - Street 2:APT 21 D
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74107-1816
Practice Address - Country:US
Practice Address - Phone:979-922-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker