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General NPI Number Information
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NPI Number | 1083945927
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Entity Type | Organization
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Legal Business Name | DONALD L FLORY PHD PC
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 01/15/2010
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Provider Practice Location Address
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Address Line | 11 CATALINA COURT
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City | EL PRADO
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State | NM
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Zip | 87529
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Country | US
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Telephone | 575-751-3848
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Fax |
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Provider Business Mailing Address
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Address Line | HC 74 BOX 21407
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City | EL PRADO
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State | NM
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Zip | 87529-9514
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Country | US
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Telephone | 575-751-3848
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DONALD L FLORY
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Credential | PH.D.
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Telephone | 575-751-3848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0965
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License Number State | NM
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