Provider Demographics
NPI:1447402177
Name:LEXANDRA, DOLORES (PHD, MSW,CAP)
Entity Type:Individual
Prefix:DR
First Name:DOLORES
Middle Name:
Last Name:LEXANDRA
Suffix:
Gender:F
Credentials:PHD, MSW,CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 A1A S
Mailing Address - Street 2:STE 11 PMB 136
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-8052
Mailing Address - Country:US
Mailing Address - Phone:954-647-5737
Mailing Address - Fax:
Practice Address - Street 1:4255 A1A S
Practice Address - Street 2:STE 11 PMB 136
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-8052
Practice Address - Country:US
Practice Address - Phone:954-647-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL53251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical