Provider Demographics
NPI:1932663523
Name:FONDOIT ALEXANDRE, WUSTHANIA (MSW)
Entity Type:Individual
Prefix:
First Name:WUSTHANIA
Middle Name:
Last Name:FONDOIT ALEXANDRE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:WUSTHANIA
Other - Middle Name:
Other - Last Name:FONDOIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:4575 NW 90TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5383
Mailing Address - Country:US
Mailing Address - Phone:786-468-3948
Mailing Address - Fax:
Practice Address - Street 1:4575 NW 90TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-5383
Practice Address - Country:US
Practice Address - Phone:786-468-3948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical