Healthcare Provider Details

I. General information

NPI: 1356973580
Provider Name (Legal Business Name): VICTORIA ALEXANDRIA FLORES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 W 250 N
MARRIOTT SLATERVILLE UT
84404-9233
US

IV. Provider business mailing address

3476 ADAMS AVE
OGDEN UT
84403-1011
US

V. Phone/Fax

Practice location:
  • Phone: 801-317-3785
  • Fax:
Mailing address:
  • Phone: 435-830-2410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13002953-3501
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: