Provider Demographics
NPI:1225454085
Name:FLORES, MARIA C (LPC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:FLORES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 PARKCENTRE WAY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-1745
Mailing Address - Country:US
Mailing Address - Phone:208-442-7791
Mailing Address - Fax:
Practice Address - Street 1:915 PARKCENTRE WAY
Practice Address - Street 2:SUITE 7
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-1745
Practice Address - Country:US
Practice Address - Phone:208-442-7791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-5508101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor