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General NPI Number Information
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NPI Number | 1790076339
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Entity Type | Individual
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Provider Name | MARLA JANAE FLOURNOY LPC, LSSP, BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/01/2011
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Last Update Date | 05/01/2011
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Provider Practice Location Address
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Address Line | 10109 ANTELOPE WAY
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City | FORNEY
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State | TX
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Zip | 75126-7879
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Country | US
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Telephone | 214-893-7795
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Fax | 972-564-6966
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Provider Business Mailing Address
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Address Line | 10109 ANTELOPE WAY
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City | FORNEY
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State | TX
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Zip | 75126-7879
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Country | US
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Telephone | 214-893-7795
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Fax | 972-564-6966
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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 | 59852
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-09-5513
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License Number State | TX
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