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General NPI Number Information
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NPI Number | 1306336599
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Entity Type | Individual
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Provider Name | RAEGAN H FLYNN LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 05/14/2018
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Provider Practice Location Address
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Address Line | 1130 SE 18TH PL
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City | OCALA
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State | FL
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Zip | 34471-5422
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Country | US
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Telephone | 352-390-6656
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Fax | 352-390-8756
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Provider Business Mailing Address
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Address Line | 1130 SE 18TH PL
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City | OCALA
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State | FL
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Zip | 34471-5422
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Country | US
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Telephone | 352-390-6656
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Fax | 352-390-8756
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH14098
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License Number State | FL
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