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General NPI Number Information
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NPI Number | 1508401142
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Entity Type | Organization
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Legal Business Name | JENNIFER FLORES
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Dates
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Enumeration Date | 11/07/2019
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Last Update Date | 11/07/2019
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Provider Practice Location Address
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Address Line | 3145 WHITEMAN DR
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City | BELLEVUE
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State | NE
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Zip | 68123-1625
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Country | US
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Telephone | 402-332-8318
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Fax | 402-939-0444
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Provider Business Mailing Address
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Address Line | 3145 WHITEMAN DR
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City | BELLEVUE
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State | NE
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Zip | 68123-1625
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Country | US
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Telephone | 402-332-8318
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Fax | 402-939-0444
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Authorized Official
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Title or Position | LMHP
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Name | JENNIFER MARIE FLORES
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Credential | MA COUNSELING
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Telephone | 402-332-8318
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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 |
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License Number State |
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