MEDICARE: ESMERALDA FLORES-BARRAZA LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	4501	MN

General Provider Information

NPI Number	:	1205673415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESMERALDA FLORES-BARRAZA LPCC

Provider Business Mailing Address
First Line	:	1720 NORFOLK AVE APT 7
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-3028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 N 1ST ST STE 234
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55401-1145
Country	:	US
Telephone Number	:	763-516-1043
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	07/15/2024

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