Provider Demographics
NPI:1053013953
Name:POULES, ISABELLA NICOLE
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:NICOLE
Last Name:POULES
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 1:14565 SIMS RD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8549
Mailing Address - Country:US
Mailing Address - Phone:561-494-4807
Mailing Address - Fax:
Practice Address - Street 1:14565 SIMS RD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8549
Practice Address - Country:US
Practice Address - Phone:561-494-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician