Provider Demographics
NPI:1891521860
Name:FLOWERS, WHITNEY ALISA
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ALISA
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MCELLAN STREET
Mailing Address - Street 2:1
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121
Mailing Address - Country:US
Mailing Address - Phone:617-801-9934
Mailing Address - Fax:
Practice Address - Street 1:81 MCLELLAN ST APT 1
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-4093
Practice Address - Country:US
Practice Address - Phone:617-801-9934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician