Provider Demographics
NPI:1821510611
Name:ZETTLER, ALEXANDRIA WYETH (ATR-BC, CTT, LMHC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:WYETH
Last Name:ZETTLER
Suffix:
Gender:F
Credentials:ATR-BC, CTT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 COLLETON CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-3640
Mailing Address - Country:US
Mailing Address - Phone:850-391-9891
Mailing Address - Fax:850-765-5120
Practice Address - Street 1:522 E PARK AVE STE 200
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2583
Practice Address - Country:US
Practice Address - Phone:850-391-9891
Practice Address - Fax:850-765-5120
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMC15771101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty