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NPI Code Detail

MEDICARE: STACEY LYNN FLORES LSW

MEDICARE: STACEY LYNN FLORES LSW
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
11041C0700XClinical Social Worker
2104100000XSocial Worker

General Provider Information

NPI Number : 1356806277
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY LYNN FLORES LSW
Provider Business Mailing Address
First Line : 3518 MONROE ST
Second Line :
City : TOLEDO
State : OH
Zip : 43606-4114
Country : US
Telephone Number : 419-724-4973
Fax Number : 419-724-4974
Provider Business Practice Location Address
First Line : 3518 MONROE ST
Second Line :
City : TOLEDO
State : OH
Zip : 43606-4114
Country : US
Telephone Number : 419-724-4973
Fax Number : 419-724-4974
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2019
Last Update Date : 02/05/2019

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Directions to “ STACEY LYNN FLORES LSW” Practice Location

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