Provider Information for 1760016810
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GEORGINA FLORES LPC
Sex: Female
NPI: 1760016810
Last Updated: 2024-07-05
Certification Date: 2024-07-05
Certification Date: 2024-07-05
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1760016810 | ||||||||||||
| Enumeration Date | 2020-02-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 425 FOREST RIDGE DR COPPELL, TX 75019-2036 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 425 FOREST RIDGE DR COPPELL, TX 75019-2036 United States Phone: 956-645-4667 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 1881 SYLVAN AVE STE 200 1330 RIVER BEND DR STE 850 | ||||||||||||
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