Provider Demographics
NPI:1104275478
Name:OXLEY, ILEANA MARIA
Entity type:Individual
Prefix:MRS
First Name:ILEANA
Middle Name:MARIA
Last Name:OXLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16321 NW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1121
Mailing Address - Country:US
Mailing Address - Phone:954-547-9497
Mailing Address - Fax:800-920-6493
Practice Address - Street 1:450 N PARK RD STE 400
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6918
Practice Address - Country:US
Practice Address - Phone:954-547-9497
Practice Address - Fax:800-920-6493
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist