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General NPI Number Information
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NPI Number | 1629558879
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Entity Type | Individual
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Provider Name | SEASON FLORES LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/17/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 900 SHUGART RD
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City | DALTON
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State | GA
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Zip | 30720-2467
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Country | US
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Telephone | 706-270-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 105 AVALON DR
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City | CALHOUN
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State | GA
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Zip | 30701-9434
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Country | US
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Telephone | 706-859-2079
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW006539
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License Number State | GA
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