Provider Demographics
NPI:1306295704
Name:WILKOSZ, ALEXANDRA A (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:A
Last Name:WILKOSZ
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:1387 FAIRPORT ROAD
Mailing Address - Street 2:SUITE 1000D
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450
Mailing Address - Country:US
Mailing Address - Phone:585-641-0281
Mailing Address - Fax:585-641-0286
Practice Address - Street 1:1387 FAIRPORT RD
Practice Address - Street 2:SUITE 1000D
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-2003
Practice Address - Country:US
Practice Address - Phone:585-641-0281
Practice Address - Fax:585-641-0286
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0824871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical