Provider Demographics
NPI:1194167569
Name:ALOISE, JESSICA THEA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:THEA
Last Name:ALOISE
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 1:12521 WOODMILL DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8938
Mailing Address - Country:US
Mailing Address - Phone:561-889-9443
Mailing Address - Fax:
Practice Address - Street 1:2051 MARTIN LUTHER KING JR BLVD STE 101
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-7007
Practice Address - Country:US
Practice Address - Phone:561-683-4778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health