Individual
MRS. ALYSSA A THAXTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1100 PLANTATION ISLAND DR S STE 110-120, ST AUGUSTINE, FL 32080-5173
(904) 824-7733
Mailing address
1100 PLANTATION ISLAND DR S STE 110-120, ST AUGUSTINE, FL 32080-5173
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
9980-C
NV
1041C0700X
Clinical Social Worker
CWS004742
GA
1041C0700X
Clinical Social Worker
Primary
SW14679
FL
Other
Enumeration date
09/21/2009
Last updated
08/01/2025
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