Provider Demographics
NPI:1164220083
Name:WOFFORD, ALEXIA R
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:R
Last Name:WOFFORD
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:ALEXIA
Other - Middle Name:R
Other - Last Name:WOFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:130 HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4571
Mailing Address - Country:US
Mailing Address - Phone:352-419-6570
Mailing Address - Fax:
Practice Address - Street 1:130 HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4571
Practice Address - Country:US
Practice Address - Phone:352-419-6570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL-25-406315106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst