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General NPI Number Information
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NPI Number | 1316681547
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Entity Type | Individual
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Provider Name | WESLEY THROWER LMHC, M.S., ED.S.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2022
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Last Update Date | 04/25/2022
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Provider Practice Location Address
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Address Line | 2236 CAPITAL CIR NE STE 104
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City | TALLAHASSEE
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State | FL
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Zip | 32308-8304
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Country | US
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Telephone | 850-766-7062
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Fax |
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Provider Business Mailing Address
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Address Line | 2634 CAPITAL CIR NE
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4106
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH19641
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License Number State | FL
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