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General NPI Number Information
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NPI Number | 1205040938
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Entity Type | Individual
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Provider Name | ANGEL FLORES LPC
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Gender | Male
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 128 S MAGDALEN ST
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City | SAN ANGELO
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State | TX
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Zip | 76903-5910
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Country | US
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Telephone | 325-212-3202
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Fax |
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Provider Business Mailing Address
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Address Line | 128 S MAGDALEN ST
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City | SAN ANGELO
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State | TX
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Zip | 76903-5910
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Country | US
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Telephone | 325-212-3202
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19493
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License Number State | TX
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