| Organization Name: | THAXTON HOLISTIC WELLNESS CENTER, LLC |
| NPI Number: | 1609243898 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SARA LYNNE THAXTON (OWNER) |
| Mailing Address: | 852 Throop St Dickson City |
| State: | PA US |
| Postal Code: | 185191457 |
| Phone Number: | 5709047363 |
| Fax Number: | |
| NPI Enumeration Date: | 08/24/2015 |
| NPI Last Update Date: | 08/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC008211 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |