Provider Demographics
NPI:1801964093
Name:CLAXTON, WYANA (LMFT)
Entity type:Individual
Prefix:
First Name:WYANA
Middle Name:
Last Name:CLAXTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 FLORIDA BLVD APT 133
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4928
Mailing Address - Country:US
Mailing Address - Phone:561-302-1820
Mailing Address - Fax:561-272-4016
Practice Address - Street 1:2525 FLORIDA BLVD APT 133
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4928
Practice Address - Country:US
Practice Address - Phone:561-302-1820
Practice Address - Fax:561-272-4016
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1688106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist